中医药从脾论治强直性脊柱炎疗效的系统评价与Meta分析

Systematic Evaluation and Meta-analysis of the Therapeutic Effect of TCM on Ankylosing Spondylitis from Spleen

目的:系统评价从脾论治对强直性脊柱炎患者疗效的影响。方法:计算机检索中国知网(CNKI)、万方(Wanfang)、维普(VIP)、中国生物医学数据库(CBM)、PubMed、Embase、Clinical Trials等数据库发表的从脾论治强直性脊柱炎的随机对照试验,检索时间为数据库建立至2020年10月,并采用Review Manager 5.2软件进行Meta分析。结果:共纳入18篇文献,共1154例患者,治疗组593例,对照组561例。Meta分析结果显示,治疗组在ASAS20(RR=1.33,95%CI=[1.16,1.52],P<0.0001)、Bath强直性脊柱炎疾病活动指数(SMD=-1.04,95%CI=[-1.44,-0.65],P<0.00001)、Bath强直性脊柱炎功能指数(SMD=-1.07,95%CI=[-1.45,-0.69],P<0.00001)、红细胞沉降率(MD=-4.32,95%CI=[-4.92,-3.72],P<0.00001)、C反应蛋白(SMD=-0.93,95%CI=[-1.07,-0.80],P<0.00001)方面均优于对照组,差异有统计学意义;治疗组不良反应发生率低于对照组(SMD=0.34,95%CI=[0.21,0.56],P<0.0001),差异有统计学意义。结论:中医药从脾论治强直性脊柱炎疗效确切,能够降低免疫炎症反应,改善关节症状,提高患者生活质量。

Objective:To systematically evaluate the effect of spleen-based treatment on ankylosing spondylitis.Methods:Databases such as CNKI,Wanfang,VIP,CBM,PubMed,Embase,and Clinical Trials were searched for randomized controlled trials on the treatment of ankylosing spondylitis from spleen.The retrieval time was from the establishment of the databases to October 2020,and Meta-analysis was carried out by using the software Review Manager 5.2.Results:A total of 18 articles were included,including 1154 patients,593 in the treatment group and 561 in the control group.Meta-analysis results showed that the treatment group was better than the control group on the aspects of ASAS20(RR=1.33,95%CI=[1.16,1.52],P<0.0001),Bath ankylosing spondylitis activity index(SMD=-1.07,95%CI=[-1.45,-0.69],P<0.00001),Bath ankylosing spondylitis function index(SMD=-1.07,95%CI=[-1.45,-0.69],P<0.00001),erythrocyte sedimentation rate(MD=-4.32,95%CI=[-4.92,-3.72],P<0.00001),and C-reactive protein(SMD=-0.93,95%CI=[-1.07,-0.80],P<0.00001),and the difference was statistically significant;The incidence of adverse reactions in the treatment group was lower than that in the control group(SMD=0.34,95%CI=[0.21,0.56],P<0.0001),and the difference was statistically significant.Conclusion:TCM treatment of ankylosing spondylitis from the spleen has an exact curative effect,and can reduce the immune inflammatory reaction and improve patients’t joint symptoms and life quality.