四妙散为主方治疗痛风性关节炎疗效与安全性的系统评价

Systematic Evaluation on Efficacy and Safety of Simiao San as Main Prescription for Gouty Arthritis

目的:评价四妙散为主方治疗痛风性关节炎的临床疗效及安全性。方法:计算机检索中国生物医学文献数据库(CBM),中国学术期刊全文数据库(CNKI),中文科技期刊数据库(VIP),万方数据库,Pub Med,EMbase,搜集四妙散为主方的中药方剂与西药对比治疗痛风性关节炎的随机对照试验;采用Cochrance系统评价的方法评价纳入文献的质量,使用Revman5.2统计软件对纳入的文献进行Meta分析。结果:共纳入13个随机对照试验,涉及1 017例患者,Meta分析结果显示,以四妙散为主方的中药方剂治疗痛风性关节炎的总有效率优于西药组,合并的OR值分别为2.28,95%CI(1.54,3.37);不良反应发生率少于西药组,合并的RR值为0.12,95%CI(0.07,0.23)。结论:四妙散为主方治疗痛风性关节炎的临床疗效及安全性较西药均有一定优势。由于纳入研究的方法学质量存在中度选择性偏倚的可能性,可能影响结果真实性,因此上述结论还有待开展更多高质量、大样本、随机双盲临床对照试验来验证。

Objective： The aim of this study was to evaluate the clinical efficacy and safety of Simiao San as the main prescription for gouty arthritis. Method： CBM,CNKI,VIP database,Wanfang database,Pub Med and EMbase were searched by computer for randomized controlled trials of Simiao San as the main prescription for gouty arthritis compared with western medicine. The quality of literatures was evaluated by using Cochrance system and Meta-analysis was performed by using Revman（ version 5. 2）. Result： A total of 12 trials involving 937 patients were included. The Meta-analysis showed that the efficiency of Simiao San as the main prescription for gouty arthritis were better than using western medicine with [OR = 2. 28,95% CI（ 1. 54,3. 37） ]. The rate of adverse drug reaction using Simiao San as the main prescription was less than using western medicine with [OR = 0. 12,95% CI（ 0. 07,0. 23） ]. Conclusion： Compared with western medicine,Simiao San as the main prescription for gouty arthritis showed higher efficiency and safety.