系统评价补阳还五汤对强直性脊柱炎临床疗效的Meta分析

A Systematic Review of Meta-Analysis of the Efficacy of Buyang Huanwu Decoction on Ankylosing Spondylitis

目的:系统评价补阳还五汤治疗强直性脊柱炎的临床疗效。方法:通过计算机检索中文数据库CNKI、万方数据库、CBM、VIP及外文数据库Pumbed、Medline、ScienceDirect,检索补阳还五汤治疗强直性脊柱炎的随机或非随机RCT,检索时间为建库至2019年03月01日。文献提取和验证由两位研究员独立完成,并采用RevMan 5.3软件进行偏倚风险评估。结果:共纳入6个RCT研究,总样本量为428例,其中试验组223例,对照组205例。Meta分析结果显示:纳入研究显示补阳还五汤能提高疗效[OR=9.93,95%CI(3.32,29.76),P<0.0001],且在晨僵上WMD=-4.14,95%CI(-6.11,-2.18),P<0.0001、BASFI WMD=-1.30,95%CI(-2.26,-0.34),P=0.008、BASDAI WMD=-1.75,95%CI(-3.34,-0.16),P=0.03、Schober WMD=0.62,95%CI(0.03,1.21),P=0.04等指标改善均优于对照组;在ESR WSMD=-0.74,95%CI(-2.42,0.93),P=0.38、CRP WSMD=-0.84,95%CI(-1.96,0.28),P=0.14指标上治疗组与对照组无明显差异。结论:补阳还五汤在治疗强直性脊柱炎上疗效尚可、安全性较好,但在改善血清学治疗上未见明显差异,仍需大样本、高质量文章论证。

Objective:The clinical efficacy of Buyang Huanwu Decoction for treatment of AS was systematically evaluated.Methods:The Chinese database CNKI,Wanfang database,CBM,VIP and foreign language database Pumbed,Medline,Science Direct were searched by computer.The random or non-random RCT of Buyang Huanwu Decoction was used to treat AS.The search time was from Building library to Mar 1st 2019.Literature extraction and validation were performed by two independently investigators.RevMan 5.3 software was used to evaluate the risk assessment.Results:From 6 RCT studies with 428 totle samples,including 223 in the experimental group and 205 in the control group,the Meta-analysis results showed that Buyang Huanwu Decoction can improve the curative effect[OR=9.93,95%CI(3.32,29.76),P<0.0001],and WMD=-4.14,95%CI(in morning stiffness)6.11,-2.18),P<0.0001,BASFI WMD=-1.30,95%CI(-2.26,-0.34),P=0.008,BASDAI WMD=-1.75,95%CI(-3.34,-0.16),P=0.03,Schober WMD=0.62,95%CI(0.03,1.21),P=0.04 and other indicators improved better than the control group,in ESR WSMD=-0.74,95%CI(-2.42,0.93),P=0.38,CRP.There was no significant difference between the treatment group and the control group in WSMD=-0.84,95%CI(-1.96,0.28)and P=0.14.Conclusion:Buyang Huanwu Decoction can be effective and safe for treatment of AS,but there is no significant difference in improving serological treatment.large samples and high quality articles demonstration were still need.