桂枝芍药知母汤对照甲氨蝶呤治疗类风湿关节炎的系统评价

Systematic Evaluation of Guizhi Shaoyao Zhimu Decoction on Rheumatoid Arthritis Compared with Methotrexate

目的比较桂枝芍药知母汤与甲氨蝶呤治疗类风湿关节炎的疗效。方法检索中国知网、维普数据库、万方数据知识服务平台、中国生物医学文献数据库和外文数据库Pubmed、Medline、Embace,搜集桂枝芍药知母汤加减对照甲氨蝶呤治疗类风湿关节炎的临床随机对照试验。由两名评价者独立提取资料并按照Cochrane风险偏倚评估工具进行风险评估。采用RevMan5.3软件进行统计学分析,其中涉及异质性检验。结果共纳入9个试验,共计779例患者。临床总有效率Meta分析结果显示:"桂枝芍药知母汤加减对照甲氨蝶呤"(RR=1.22,95%CI[1.13,1.32],P<0.00001)。结论桂枝芍药知母汤对照甲氨蝶呤在治疗类风湿关节炎临床总有效率方面有较显著优势,但上述结论还需更多高质量的大样本随机对照试验加以验证。

Objective:To compare the efficacy of Guizhi Shaoyao Zhimu Decoction and methotrexate on rheumatoid arthritis.Methods:CNKI,VIP database,Wanfang data knowledge service platform,Chinese biomedical literature database and foreign database-Pubmed,Medline,Embace were retrieved,and the clinical randomized controlled trials of Guizhi Shaoyao Zhimu Decoction plus or minus control methotrexate in the treatment of rheumatoid arthritis were collected.Two evaluators independently extracted data and conducted risk assessment according to Cochrane risk bias assessment tool.Rev Man 5.3 software was used for statistical analysis,which involved heterogeneity testing.Results:9 trials involving 779 patients were included.Meta-analysis of clinical total effective rate showed that Guizhi Shaoyao Zhimu Decoction plus or minus control methotrexate RR=1.22,95%CI[1.13,1.32],P<0.00001.Conclusion:Guizhi Shaoyao Zhimu Decoction has significant advantages over methotrexate on rheumatoid arthritis,but the above conclusions need to be verified by more high-quality large sample randomized controlled trials.