白芍总苷治疗类风湿关节炎疗效及安全性Meta分析

A Meta-Analysis of the Efficacy and Safety of Rheumatoid Arthritis Treated with Total Glucosides of Paeony

目的 :系统分析评价白芍总苷治疗类风湿关节炎(RA)的疗效及安全性。方法:计算机检索中国知网、万方医学数据库、维普中文科技期刊全文数据库有关"白芍总苷"联合免疫抑制剂应用于治疗类风湿关节炎的临床疗效及安全性的随机对照研究。采用Rev Man 5.3软件进行Meta分析。结果:通过数据库检索符合要求的文献10篇,入选患者741例。有9项研究实验组临床疗效优于对照组(OR=2.97,95%CI 1.63~5.60,Z=3.54,P<0.0001)。有6项研究治疗后两组晨僵时间均缩短,但实验组缩短更明显,MD(95%CI)为-0.11(-183.42^-60.03),Z=3.61,P<0.0001。有8项研究治疗后两组关节肿胀个数均减少,但实验组减少更明显,MD(95%CI)为-0.12(-175.13^-62.04),Z=3.72,P<0.0001。有8项研究治疗后两组红细胞沉降率水平下降,但实验组下降更明显,MD(95%CI)为-0.12(-179.43^-64.05),Z=3.84,P<0.0001。有9项研究实验组不良反应发生情况优于对照组。结论:白芍总苷治疗类风湿关节炎疗效较好,安全性高。

Objective：To systematically evaluate the efficacy and safety of total glucosides of paeony for rheumatoid arthritis. Methods ： From the CNKI, Wanfang Data and VIP, randomized cotltrolled trials （RCTs） on efficacy and safety of total glucosides of paeony combined with immunosuppressant for rheumatoid arthritis were retrieved. RevMan 5.3 was applied for meta-analysis. Results：Ten references were included with 741 patients. In 9 RCTs,clinical efficacy of the experimental group was better than that of control group（OR= 2.97,95%CI 1.63 to 5.60,Z=3.54,P〈0.0O001）. In 6 RCTs,after treatment,the time of morning stiffness were reduced,and in the experimental group,it was reduced more obviously（MD=0.11,95%CI 183.42 -- 60.03 , Z= 3.61,P〈0.0001）. In 8 RCTs,after treatment,the number of joint swelling was reduced,and in the experi- mental group,it was reduced more obviously（MD=0.12,95%CI 175.13N62.04,Z=3.72,P〈0.0001）. In 8 RCTs,after treatment,erythrocyte sedimentation rateps decreased,and in the experimental group it decreased more obviously（MD=0.12,95% CI 179.43-- 64.05,Z=3.84,P〈 0.0001）. In 9 RCTs, adverse reaction was less in the experimental group. Conclusion：Total glucosides of paeony for rheumatoid arthritis is of better effect and higher safety.