中医药治疗强直性脊柱炎有效性的系统评价和Meta分析

Systematic Evaluation and Meta-analysis of the Efficacy of Chinese Medicine in the Treatment of Ankylosing Spondylitis

目的:系统评价中医药治疗强直性脊柱炎的有效性和安全性。方法:计算机检索中国知网、万方、维普、Pub Med、Cochrane Library、Clinical trials等数据库中收录的中医药治疗强直性脊柱炎的临床随机对照研究,检索时间为数据库建立至2019年2月。依据Jadad进行质量评估,并采用Rev Man5.3软件进行Meta分析。结果:检索到文献3459篇,筛选后纳入20篇,共1859例研究对象。中药+常规治疗改善Bath强直性脊柱炎活动指数(BASDAI)(MD=2.79,95%CI=[2.02,3.85],P <0.000 1),Bath强直性脊柱炎功能指数(BASFI)(MD=-0.71,95%CI=[-1.21,-0.22],P=0.005),指地距(MD=-2.53,95%CI=[-4.04,-1.02],P=0.001),胸廓活动度(MD=0.27,95%CI=[0.07,0.46],P=0.007),Sch?ber试验(MD=0.44,95%CI=[0.07,0.80],P=0.02),红细胞沉降率(ESR)(MD=-5.29,95%CI=[-7.13,-3.45],P <0.000 01),C-反应蛋白(CRP)(MD=-4.13,95%CI=[-6.00,-2.25],P <0.000 1)疗效优于常规治疗。结论:中医药治疗强直性脊柱炎具有确切的疗效,在改善BASDAI、BASFI、指地距、胸廓活动度、Sch?ber试验、ESR、CRP均优于常规干预。

Objective:To systematically evaluate the efficacy and safety of Chinese medicine in the treatment of ankylosing spondylitis.Methods:Randomized controlled clinical trials using Chinese medicine in the treatment of ankylosing spondylitis(from the establishment of database to February 2019)were retrieved from the databases of CNKI,Wanfang Data,Wip,Pub Med,Cochrane Library,Clinical trials and so on.Quality evaluation was conducted according to Jadad and meta-analysis was carried out with software Rev Man 5.3.Results:A total of 3459 articles were retrieved,20 articles were included after screening,and a total of 1859 subjects were studied.Chinese medicine combined with routine treatment improved BASDAI(MD = 2.79,95%CI =[2.02,3.85],P < 0.000 1);BASFI(MD =-0.71,95%CI =[-1.21,-0.22],P = 0.005),finger-to-ground distance(MD =-2.53,95%CI =[-4.04,-1.02],P = 0.001),thoracic activity(MD = 0.27,95%CI =[0.07,0.46],P = 0.007,Sch?ber test(MD = 0.44,95%CI =[0.07,0.80],P = 0.02),ESR(MD =-5.29,95%CI =[-7.13,-3.45],P < 0.000 01,and CRP(MD =-4.13,95%CI =[-6.00,-2.25],P < 0.000 1),superior to conventional treatment.Conclusion:Chinese medicine has definite curative effect on ankylosing spondylitis.It is superior to routine intervention in improving BASDAI,BASFI,finger-to-ground distance,chest mobility,Sch?ber test,ESR and CRP.