中药外治法治疗类风湿关节炎的Meta分析

Meta analysis of external therapies of TCM in treating rheumatoid arthritis

目的:系统评价中药外治法治疗类风湿关节炎患者的疗效。方法:检索PubMed数据库、中文科技期刊数据库、中国生物医学文献数据库、中国期刊全文数据库、万方数据库,以中药外治单独或联合西药与单用西药治疗的随机对照试验为研究对象,根据Cochrane协作网质量评价标准提取资料,采用RevMan 5.0软件进行资料分析,以临床疗效、症状和体征、不良反应为效应指标。结果:共纳入9篇研究共817例患者,中药外治组459例,对照组358例。5个试验显示中药外治疗效更高(P<0.01),4个试验显示中药外治组治疗后关节疼痛指数更低(P<0.01),5个试验显示治疗后关节肿胀指数低于西医对照组(P<0.01),6个研究显示中药外治组治疗后关节晨僵改善率更高(P<0.01)。结论:中药外用治疗较单纯西医治疗更具有疗效优势。

Objective： To analyze the clinical efficacy of the external therapies of TCM in treatment for rheumatoid arthritis （RA）. Methods： With External Therapies and TCM and RA＇ as search word, to retrieve published articles of domestic and external from PubMed, VIP, CBM, CNKI and Wanfang database. The quality of included studies was assessed according to the criteria recommended Cochrane Collaboration, Meta-analysis were performed using RevMan 5.0 software. Results： 9 RCTs involving 871 patients were included, experimental group was 459, control group was 358. Five researches showed that the effective rate of experimental group was better than that of control group （P〈0.01）, four researches showed the joint pain index and five researches showed the swollen joint count index of experimental group were lower than control group （P〈0.01）, and six researches showed the improvement rate of joint morning stiffness of experimental group was higher than control group （P〈0.01）. Conclusion： External therapies of TCM may be more beneficial in treatment of RA compared with only western medicine treatment, but its efficacy and safety need to be confirmed with high-quality randomized controlled trials.