玉屏风散加减联合常规药物治疗单纯疱疹病毒性角膜炎有效性和安全性的meta分析

Effectiveness and Safety of Modified Yupingfeng Powder Combined with Routine Medical Therapy for Herpes Simplex Keratitis:a Systematic Review and Meta-analysis

目的评价玉屏风散加减联合常规药物治疗单纯疱疹病毒性角膜炎的有效性和安全性。方法通过检索CENTRAL、Pub Med、EMbase、CBM、CNKI、中文科技期刊数据库(VIP)、万方数据库,并获取玉屏风散治疗单纯疱疹病毒性角膜炎的随机对照试验文献,在采用Cochrane偏倚风险评估工具对纳入研究进行方法学质量评估基础上,用Rev Man 5.3软件进行meta分析。结果 10个研究包括955例病例被纳入,meta分析结果表明,玉屏风散加减联合常规药物治疗的疗效优于单纯使用常规药物治疗,RR=1.12(95%CI:1.04,1.21);且复发率也低于常规药物治疗组,RR=0.21(95%CI:0.14,0.30);但倒漏斗图提示可能存在潜在的发表性偏倚。10个研究对不良事件或不良反应报告不充分。结论尽管玉屏风散加减联合常规药物治疗用于单纯疱疹病毒性角膜炎的疗效优于单用常规药物治疗,但所纳入研究的方法学质量较差,结论须谨慎应用。

Objective To evaluate the effectiveness and safety of modified Yupingfeng Powder（YP）combined with routine medical therapy for the treatment of patients with herpes simplex keratitis. Methods All randomized controlled trials（RCTs）of YP for treatment of herpes simplex keratitis were searched from the databases of CENTRAL,Pub Med,EMbase,CBM,CNKI,VIP and Wanfang. The assessment tool of risk of bias issued by Cochrane Handbook was used to evaluate methodological quality of included literatures, and Rev Man 5.3 software was applied for Meta- analysis.Results Ten RCTs involving 955 patients were included. The Meta- analysis results showed that modified YP combined with routine medical therapy had better effectiveness than the routine medical therapy alone（RR： 1.12, 95 % CI：1.04- 1.21）. The recurrence rate in the group of modified YP plus routine medical therapy was lower than routine medical therapy group（RR：0.21, 95 % CI： 0.14- 0.30）. The funnel plot suggested that there was a potential publication bias. The adverse events or adverse reactions were reported insufficiently in the included RCTs. Conclusion The modified YP combined with routine medical therapy has better effectiveness than routine medical therapy alone for herpes simplex keratitis,but the conclusion should be cautious to be interpreted for the low methodological quality of the included studies.