白虎加桂枝汤治疗痛风性关节炎临床疗效的Meta分析

A Meta Analysis of Clinical Efficacy of White Tiger Decoction Combined with Cinnamon Twig Decoction on Acute Gouty Arthritis

目的:分析评价白虎加桂枝汤治疗痛风性关节炎的临床疗效。方法:通过检索中国知网、万方数据库、维普网、中国生物医学文献数据库、Pubmed等国内外数据库公开发表的白虎加桂枝汤治疗痛风性关节炎的随机对照试验(randomized controlled trial, RCT)。用Cochrane协作网提供的RevMan 5.3软件进行Meta分析,比较分析白虎加桂枝汤与西药治疗痛风性关节炎的临床疗效、不良反应、尿酸、血沉、C反应蛋白。结果:筛选出10篇文献,共959例患者,Meta分析结果显示,白虎加桂枝汤治疗痛风性关节炎在临床疗效[OR=2.76,95%CI(1.88,4.06),P<0.000 01]、降低尿酸[SMD=-1.10,95%CI(-1.49,-0.72),P<0.000 01]、降低血沉[SMD=-0.51,95%CI(-0.87,-0.16),P=0.004]、降低C反应蛋白[SMD=-2.84,95%CI(-3.16,-2.52),P<0.000 01]方面优于西药治疗,且不良反应发生率低于西药[RR=0.17,95%CI(0.06,0.47),P=0.000 8]。结论:白虎加桂枝汤治疗痛风性关节炎疗效高于西药治疗,能改善尿酸、血沉以及C反应蛋白水平,降低不良反应发生率。

Objective:To analyze and evaluate the clinical efficacy of White Tiger Decoction combined with Cinnamon Twig Decoction on acute gouty arthritis.Methods:The randomized controlled trial(RCT)of White Tiger Decoction combined with Cinnamon Twig Decoction in the treatment of gouty arthritis published in CNKI,Wanfang database,VIP,China biomedical literature database,PubMed and other databases at home and abroad was searched.The RevMan 5.3 software provided by Cochrane Collaboration Network was used for Meta-analysis to compare and analyze the clinical efficacy,adverse reactions,uric acid,ESR and C-reactive protein of White Tiger Decoction combined with Cinnamon Twig Decoction and Western medicine in the treatment of acute gouty arthritis.Results:A total of 10 literatures were selected involving 959 patients.The results of Meta-analysis showed that White Tiger Decoction combined with Cinnamon Twig Decoction was superior to Western medicine in the treatment of acute gouty arthritis in clinical efficacy,[OR=2.76,95%CI(1.88,4.06),P<0.00001],decreasing uric acid[SMD=-1.10,95%CI(-1.49,-0.72),P<0.00001],decreasing ESR[SMD=-0.51,95%CI(-0.87,-0.16),P=0.004],decreasing C-reactive protein[SMD=-2.84,95%CI(-3.16,-2.52),P<0.00001],and the incidence of adverse reactions was lower than that of Western Medicine[RR=0.17,95%CI(0.06,0.47),P=0.0008].Conclusion:White Tiger Decoction combined with Cinnamon Twig Decoction is more effective in the treatment of acute gouty arthritis than Western medicine.It can improve the levels of uric acid,ESR and C-reactive protein and reduce the incidence of adverse reactions.