补肾法联合环孢素A+雄激素治疗慢性再生障碍性贫血的Meta分析

A Meta-Analysis of Kidney Tonifying Combined with Cyclosporine A+Androgen in the Treatment of Chronic Aplastic Anemia

目的系统性评价补肾法联合环孢素+雄激素方案治疗慢性再生障碍性贫血(CAA)的安全性和有效性,为临床应用和深入研究提供基础。方法检索补肾法联合环孢素+雄激素治疗CAA的随机对照试验(RCTs),无盲法及语言等限制;筛选符合纳入标准的RCTs,依据Jadad评分法对文献进行质量评价,剔除3分以下的文献纳入最后研究,并采用Revman 5.3软件进行Meta分析。结果共纳入9篇文献,Jadad评分均为3分,纳入病例共494名。Meta分析:补肾法中药联合环孢素A+雄激素治疗CAA在疗效、中医证候积分、外周血象方面效果优于单纯西药治疗,同时在减轻环孢素及雄激素不良反应方面具有明显的优势(P<0.0001),差异具有统计学意义。结论补肾法联合环孢素A+雄激素治疗CAA的效果及安全性优于单纯应用环孢素A+雄激素。

Objective To systematically evaluate the safety and effectiveness of the kidney-tonifying method combined with cyclosporine+androgen regimen in the treatment of chronic aplastic anemia(CAA),to provide a basis for clinical application and in-depth research.Methods The randomized controlled trial(RCTs)of CAA with renal tonifying combined with cyclosporine androgen was performed without the limitation of blindness and language.And the quality of literature was evaluated according to Jadad scoring method.The literature below 3 points was included in the final study.Meta-analysis was performed using Revman 5.3 software.Results A total of 9 articles were included,all with a Jadad score of 3,and a total of 494 cases were included.Meta-analysis results:Chinese medicine for invigorating the kidney combined with cyclosporin A+androgen treatment of CAA is more effective than western medicine in terms of western medical effect,TCM syndrome integral,and peripheral blood picture.At the same time,it has obvious effect in reducing the adverse reactions of cyclosporine and androgen Advantage,the difference is statistically significant(P<0.0001).Conclusion The effect and safety of tonifying the kidney combined with cyclosporin A+androgen in the treatment of chronic aplastic anemia are better than cyclosporin A+androgen alone,and it is worthy of further clinical promotion and research.