蜂针治疗类风湿关节炎的系统评价及Meta分析

Bee-sting Therapy for Rheumatoid Arthritis: A Systematic Review and Meta-analysis

目的:评价蜂针疗法治疗类风湿关节炎(RA)的临床疗效及研究现状。方法:系统检索各文献数据库,搜集蜂针疗法治疗RA的相关临床文献,运用Revman 5.3软件对其总有效率、血沉(ESR)、C-反应蛋白(CRP)、类风湿因子(RF)效应结局指标进行分析。结果:共纳入8项RCT包括496例患者,经分析蜂针对总有效率、ESR、CRP、RF比较差异有统计学意义[分别为OR=3.37,95%CI(1.95,5.84),P=0.0001;MD=-4.25,95%CI(-7.44,-1.06),P=0.009;MD=-3.12,95%CI(-6.29,-0.06),P=0.05]。结论:Meta分析结果表明,相对于西药治疗蜂针治疗RA的疗效结果存在明显优势。本系统评价纳入研究质量较低,可能存在偏倚,影响结果的论证强度,需要进行更高质量的随机对照双盲试验证实。

Objective： To evaluate the curative effect and status of Bee-sting therapy in the treatment of Rheumatoid Arthritis.Methods： A systematic retrival has been taken in Chinese National Knowledge Infrastructure,Chinese biomedical literature database,VIP journal full text database,Wanfang database,MEDLINE,Cochrane Library and Springer. Collect RCT literatures concerning the treatment of Rheumatoid Arthritis with Bee-sting therapy. Two reviewers independently screened literature,extracted data and assessed the risk of bias of included studies. Then meta-analysis was conducted by Rev Man 5. 3 software. Results： A total of 8 RCTs,involving 496 patients were included,the results of Metaanalyses indicated that compared with therapy of western medicine,Bee-sting therapy for RA was superior in the total effective rate（ OR = 3. 37,95% CI（ 1. 95,5. 84）,P = 0. 0001）,ESR（ MD =-4. 25,95% CI（-7. 44,-1. 06）,P =0. 009）,and CRP（ MD =-3. 12,95% CI（-6. 29,-0. 06）,P = 0. 05） with significant differences. Conclusion：According to the results of the meta-analysis,Bee-sting therapy for Rheumatoid Arthritis is better than the western medicine treatment. Due to the poor quality and high possibility of bias of the included studies,more well-designed multicentered RCTs should be performed.