蜂针治疗类风湿关节炎Meta分析

Bee Therapy for Treatment of Rheumatoid Arthritis: A Meta Analysis

目的:系统评价单用蜂针或蜂针联合其他方法治疗类风湿性关节炎的效果。方法:检索中国生物医学文献数据库(CBM)、万方数据资源系统(Wan Fang Data)、中国知网(CNKI)、中文科技期刊数据库(VIP)截至2016年3月29日的文献,用Cohrane协作网系统综述手册5.0标准评价文献质量,用Rev Man 5.2软件进行Meta分析。结果:纳入文献11篇,共738例;单用蜂针的总有效率高于布洛芬+中药制剂(P<0.05);单用蜂针与甲氨蝶呤、单用蜂针与甲氨蝶呤+塞来昔布的总有效率比较无显著差异(P>0.05);蜂针+甲氨蝶呤与甲氨蝶呤、蜂针+甲氨蝶呤+柳氮磺吡啶+美洛昔康与甲氨蝶呤+柳氮磺吡啶+美洛昔康、蜂针+中药熏洗+芬必得+来氟米特+甲氨蝶呤与芬必得+来氟米特+甲氨蝶呤、蜂针+中药外敷+青霉素+双氯芬酸钠与青霉素+双氯芬酸钠的总有效率均是前者高于后者(P<0.05或P<0.01);蜂针+养血通痹汤与非甾体类消炎镇痛药+激素、蜂针+雷公藤与雷公藤的总有效率比较无显著差异(P>0.05)。结论:单用蜂针或联合蜂针能提高类风湿关节炎的疗效,但需更多高质量、大样本的随机对照试验证实。

Objective： To systematically evaluate the clinical therapeutic effect of bee therapy for the treatment of rheu- matoid arthritis. Methods： Randomized control trials （RCTs） and quasi -randomized control trials （CCTs） that met the inclusive criteria were identified with the deadline of 3 -29 -2016 from CBM ,Wan Fang Data base, CNKI and VIP. Two reviewers extracted and evaluated the data independently with a specially designed extraction form. Cochrane systematic review method was used and Revmen 5.2.0 software was adopted to perform this Meta analysis. Results ： Totally 11 arti- cles were included, and 738 cases of rheumatoid arthritis were involved. The results indicated that the effective rate of bee therapy for the treatment of rheumatoid arthAtis was superior to those of the ibuprofen ＋ traditional Chinese medicine （TCM） group（ P 〈 0. 05 ）. The comparison of the effective rate of the treatment of rheumatoid arthritis had no statistical discrepancy between bee therapy and methotrexate （MTX） and between bee therapy and MTX combining Celecoxib（P 〉 0.05 ）. The comparison of the effective rate of the treatment of rheumatoid arthritis had statistical discrepancy between bee therapy combining MTX and MTX and between bee therapy combining MTX ＋ sulfasalazine ＋ melodica and MTX ＋ sulfasalazine ＋ melodica and between therapy combining Herbal fumigation ＋ fenbid ＋ leflunomide ＋ MTX and Fenbid ＋ le- flunomide ＋ MTX and between therapy combining external application of Chinese medicine ＋ penicillin ＋ diclofenac sodi- um and penicillin ＋ diclofenac sodium（ P ≤ 0. 05 or P 〈 0.01 ）. The comparison of the effective rate of the treatment of rheumatoid arthritis had no statistical discrepancy between bee therapy combining TCM and nonsteroidal anti inflammatory drug （NSAID） ＋ hormone and between bee therapy combining tripterygium glycosides and tripterygium glycosides. （P 〉0. 0）. Conclusion： It indicated that bee therapy was effective for rheumatoid arthritis and had some advantages compared with the control group. But the quality of the literature included in this study was not good enough. More high - quality randomized control trials with large samples are needed to further confirm the effect of bee therapy on rheumatoid arthritis.