四妙散对比西药治疗痛风及影响血尿酸降解速度的Meta分析与系统评价

A Systematic Review and Meta-Analysis of Simiao Powder in Treatment of Gout Arthritis and Uric Acid

目的:探究四妙散原方对比西药治疗痛风性关节炎的疗效及血尿酸降解速度的影响,并系统评价其方法学质量。方法:搜索中国知网、维普医学数据库、万方医学数据库、中国生物医学文献网及pubmed数据库,纳入四妙散原方对比西药治疗痛风性关节炎的随机对照试验(RCT)文献,排除四妙散加减的RCT文献。采用Cochrane系统评价员手册进行偏倚风险评估,对临床疗效、血尿酸疗效进行Meta分析。结果:共纳入9篇RCTs文献,四妙散治疗痛风临床疗效的合并RR值为1.26,95%CI(1.12,1.42)(P<0.05);治疗后尿酸的合并效应量加权均数差为-98.59μmol/L,95%CI为(-153.34,-43.84)μmol/L。安全性方面四妙散治疗没有增加不良反应(P<0.05)。结论:对比单纯使用西药,四妙散原方治疗痛风有更好的临床疗效,明显降低尿酸且没有增加不良反应,药味简单,适合临床的推广使用。但由于纳入的文献质量不高,需要进一步开展高质量的大样本双盲随机对照试验。

Objective： To explore the clinical effect of the treatment of gout arthritis and uric acid with Simiao Powder original recipe and evaluate the quality of the method. Methods： Chinese biomedical,CNKI,Wanfang database and Pubmed were searched.Simiao Powder treatment randomized control trials（ RCT） of gouty arthritis literature,excluding patients in treatment group were treated with modifying multiple drugs in Simiao Powder. Cochrane risk assessment scale was used to evaluate the efficacy and serum uric acid for Meta- analysis. Results： A total of 9 articles were included. In the treatment of gout,the clinical efficacy RR value was 1. 26 with 95% CI（ 1. 12,1. 42）（ P〈0. 05）. And after treatment,the uric acid combined mean difference value was- 98. 59μmol/L with 95% CI（- 153. 34,- 43. 84） μmol/L. Conclusion： Compared with simple western medicine,Simiao Powder in the treatment of gout has better clinical efficacy,significantly lowering the uric acid and no increase in adverse reaction. The prescription has simple ingredients,suitable for clinical promotion. However,the quality of the included literature is not high,and it is needed to carry out a large sample of high quality and large number of double blind randomized controlled trials.