补肾祛寒治尪汤联合甲氨蝶呤治疗类风湿关节炎系统综述

Systematic review on rheumatic arthritis treated with bushen quhan zhiwang decoction and methotrexate

目的运用系统综述的方法对补肾祛寒治尪汤联合甲氨蝶呤治疗类风湿关节炎(rheumatoid arthritis,RA)的临床疗效及安全性进行评估。方法通过对中国学术期刊全文数据库、中国生物医学文献数据库、万方数据库、维普中文科技期刊全文数据库、Pubmed数据库进行相关文献进行检索,筛选出补肾祛寒治尪汤联合甲氨蝶呤的临床随机对照试验。采用Cochrane协作网系统评价的方法对文献进行资料提取,并对文献进行方法学质量评估。对所纳入的数据使用Rev Man5. 3. 0软件对数据进行分析。结果筛选出符合纳入标准文献6篇,补肾祛寒治尪汤联合甲氨蝶呤较之于单用甲氨蝶呤,患者28关节的疾病活动评分(Disease activity score in 28 joints,DAS28)、红细胞沉降率(erythrocyte sedimentation rate,ESR)、肿胀关节数目,C反应蛋白(C-reactionprotein,CRP)两组间差异无统计学意义(P> 0. 05),联合用药组不良反应减少。结论较之于单用甲氨蝶呤,补肾祛寒治尪汤联合甲氨蝶呤能够提高RA的临床疗效并降低相关副作用。

Objective To evaluate the clinical effects and safety on rheumatoid arthritis(RA) treated with bushen quhan zhiwang decoction and methotrexate(MTX),using systematic review method. Methods The relevant papers were retrieved from CNKI,ECBD,Wanfang,VIP and Pubmed databases. The RCTs with the combined medication of bushen quhan zhiwang decoction and MTX were screened. The method of Cochrane Collaboration Network was adopted to extract the data from the papers. The quality of literature was evaluated and the included data were analyzed with Rev Man 5. 3. 0 software. Results A total of 6 papers were eligible. Compared with the simple use of MTX,there were no differences in DAS-28 score,ESR,joint swelling number and CRP in the combined medication of bushen quhan zhiwang decoction and MTX(P > 0. 05). The adverse reaction was reduced in the combined medication group. Conclusion Compared with the simple use of MTX,the combined medication of bushen quhan zhiwang decoction and MTX improves the clinical effects and reduces the relevant side effects in treatment of RA.