中药药浴治疗寻常型银屑病疗效及对生活质量影响的Meta分析

A meta-analysis of the efficacy and quality of life of Chinese herb bath in the treatment of psoriasis vulgaris

目的系统评价中药药浴治疗寻常型银屑病的临床疗效。方法使用Meta分析系统评价中药药浴治疗寻常型银屑病的临床疗效,计算机检索中国知网(CNKI)、万方数据知识服务平台、维普中文期刊数据库(VIP)、中国生物医学文献数据库(CBM),PubMed,Cochrane Library,EMbase数据库,用主题词+自由词的方式检索中药药浴治疗寻常型银屑病的随机对照试验,检索时限均为自建库至2018年11月,由两名研究人员分别对检索出的文献进行筛选分析,使用Cochrane偏倚风险评估方法评价纳入文献的质量及偏倚风险,应用RevMan5.3软件进行Meta分析。结果最终纳入14项随机对照试验(RCT),共计1729例患者。对其有效率进行评估,14个RCT的实验组治疗的有效率均高于对照组,(OR=3.97,95%CI[2.82,5.60],Z=7.90,P<0.00001)差异具有统计学意义;5篇RCT对生活质量改善情况进行评估,其实验组的DLQI评分均高于对照组,(WMD=-2.51,95%CI[-3.51,-1.51],Z=4.91,P<0.00001)差异具有统计学意义。结论使用中药药浴治疗寻常型银屑病,在治疗有效率与改善患者生活质量方面均优于单纯使用其他基础治疗,但由于所纳入的文献存在一定偏倚,因此此结论尚需大量大样本、多中心、双盲的随机对照试验进行验证其有效性和安全性。

Objective To explore the clinical efficacy of Chinese Herb Bath in treating psoriasis.Methods Using Meta analysis system for evaluation of traditional Chinese medicine medicated bath treatment of clinical curative effect with psoriasis vulgaris,computer retrieval China hownet(CNKI),ten thousand data knowledge service platform,VIP,the Chinese biomedical literature database(CBM),PubMed,the Cochrane Library,EMbase database,use subject words+free word way to retrieve Chinese medicine medicated bath therapy randomized controlled trials with psoriasis vulgaris,are the self-built database retrieval time until December 2018 Literature selection and information extraction was completed and screened by two independent reviewers,and then the Cochrane recommended bias risk assessment method was used to evaluate the bias risk,and Review Manager 5.3was used for the data analysis.Results Totally 14clinical RCTs were included in this study,involving 1729 patients.The effective rate of the treatment in the 14 RCT experimental groups was higher than that in the control group(OR=3.97,95%ci[2.82,5.60],Z=7.90,P<0.00001).Five RCTS assessed the improvement of quality of life.DLQI scores of the experimental group were all higher than those of the control group(WMD=-2.51,95%CI[-3.51,-1.51],Z=4.91,P<0.00001),and the difference was statistically significant.Conclusion Using Chinese herb bath treatment for psoriasis vulgaris is superior to other basic treatments in terms of treatment efficiency and improvement of patients'quality of life.But because there is a certain bias into the literature,so this conclusion still needs a large number of large sample,multicenter,double-blind randomized controlled trial to validate its effectiveness and safety.