中药联合甲氨蝶呤治疗类风湿关节炎临床疗效的Meta分析

Meta-analysis of Treating Rheumatoid Arthritis with Traditional Chinese Medicine Combined with Methotrexate

目的:探讨中药联合甲氨蝶呤治疗类风湿关节炎的临床疗效。方法:搜索检索Pubmed与Embase外文数据库,CNKI及Wanfang中文数据库,纳入中药联合甲氨蝶呤与单纯甲氨蝶呤治疗类风湿关节炎的随机对照试验(RCT)文献,用Cochrane系统评价手册进行质量评分,对总有效率、血沉(ESR)、C反应蛋白(CRP)、类风湿因子(RF)进行Meta分析。结果:共纳入5篇RCT文献进入对照研究,Meta分析显示,中药联合甲氨蝶呤治疗组总疗效优于单纯甲氨蝶呤对照组(P<0.05),并且治疗组降低CRP、ESR、RF效果均优于对照组(P<0.05)。结论:对比单纯使用甲氨蝶呤,联合中药治疗类风湿关节炎有更好的临床疗效,且没有增加不良反应,适合临床推广,但由于纳入文献质量不高,需要进一步开展高质量随机对照试验。

Objective ： To observe the clinical effect of treating Rheumatoid Arthritis with traditional Chinese medicine combined with Methotrexate. Method： Systematic literature search were performed in Pub - reed, Em -base, China National Knowledge Infrastructure （CNKI） and Wanfang database. Randomized control trails （RCT） about traditional Chinese medicine combined with methotrexate in treating patients with rheumatoid arthritis were enrolled. The quality of the RCT were evaluated by using Chchrane risk of bias manual. The effectiveness （clinical effect, ESR, CRP, RF） and safety were evaluated by using meta- analysis. Result： A total of 5 articles were included. Compared with using methotrexate along, treating rheumatoid arthritis with traditional Chinese medicine combined with methotrexate had a significantly higher clinical efficacy （ P 〈 0. 05 ） and a better result in lowering ESR, CRP, and RF level（P 〈 0. 05 ）. Conclusion： Traditional Chinese medicine combined with methotrexate has a better clinical effect, and there was no increase in the side effect. It is worthy of clinical promotion. However, because of the quality of included literature, it is necessary to carry out high - quality RCT.