中西医结合治疗寻常型银屑病疗效的Meta分析

A Meta-analysis of treating psoriasis vulgaris in the integrative medicine

目的:系统评价中西医结合治疗寻常型银屑病的疗效及安全性。方法:计算机检索Pub Med、OVID、EMbase、The Cochrane Library、CBM、CNKI、Wan Fang Data和VIP数据库,检索时间为2010年-2014年11月,纳入有关中西医结合治疗寻常型银屑病的随机对照试验。设计文献资料提取表,由2名研究者按纳入与排除标准独立筛选文献、提取资料、评价文献偏倚风险,最后使用Rev Man5.2.6软件进行Meta分析。结果:共纳入13个RCTs,包括1075例患者。Meta分析结果显示:中西医结合治疗临床有效率(%)高于对照组[RR=1.10,95%CI(1.03,1.18),P=0.003];治疗后血浆内皮素(ET)含量[MD=-11.39,95%CI(-13.07,-10.01)]、皮损面积症状积分[MD=-1.29,95%CI(-2.54,-0.04)]、红斑丘疹症状积分[MD=-0.97,95%CI(-1.24,-0.70)]、鳞屑症状积分[MD=-0.60,95%CI(-0.88,-0.32)]、瘙痒症状积分[MD=-1.08,95%CI(-1.40,-0.75)]等方面均较西药常规治疗组有所下降。纳入研究均未报告由中西医结合治疗引起的频繁或严重不良反应。结论:该Meta分析表明中西医结合干预可降低患者血浆内皮素(ET)含量,改善皮损面积、红斑丘疹、鳞屑、瘙痒等症状,且不良反应少。但现有研究方法学及报道质量偏低,以上结果仍需进一步严格试验设计的大样本研究来证实。

Objective： To evaluate clinical efficacy and safety of the integrative medicine on psoriasis vulgaris. Methods：PubMed, OVID, EMbase, the Cochrane library, CBM, CNKI, Wanfang Data and VIP database were searched from 2010 to November 2014,aboute treating psoriasis vulgaris in the integrative medicine for randomized controlled trials. Results： 13 RCTs were included, including 1075 patients. Meta-analysis showed that clinical efficacy of the integrative medicine was higher than the control; Plasma endothelin （ET） content, the lesion area symptom score, red rash symptom score, symptom score scales;itching symptom score were lower than the routine western medicine group. Frequent or severe adverse reactions due to the integrative medicine were not reported. Conclusion：This Meta-analysis showed that the integrative medicine can reduce plasma endothelin （ET） content, improve lesion area, red rash, scaling, itching and other symptoms, and fewer adverse reactions. However, more studies need further stringent tests designed to confirm the results.