中药复方干预亚临床甲状腺功能减退症疗效的Meta分析

Therapeutic Efficacy of Chinese Herbal Prescriptions on Subclinical Hypothyroidism:A Meta-Analysis

目的评价中药复方干预亚临床甲状腺功能减退症(Sublclinical hypothyroidism,SCH,简称亚临床甲减)的临床疗效及安全性。方法计算机检索中国知网(CNKI)、中文科技期刊全文数据库维普资讯(VIP)、万方数据知识平台、PubMed、EmBase及the Cochrane Library发表的有关中药干预亚临床甲减的随机对照试验。由两名研究者独立对纳入研究进行资料提取和方法学质量评价,采用RevMan 5.3软件进进行Meta分析。结果共纳入13项研究,共820例受试者。Meta分析结果显示,中药治疗与西药治疗的临床总疗效比较,差异有统计学意义(P<0.05);中药复方联合西药与西药治疗的临床疗效比较,差异有统计学意义(P<0.01);中药复方联合西药与西药治疗后的促甲状腺激素(TSH)水平低于西药组,差异有统计学意义(P<0.05);中药组干预后的总胆固醇水平低于西药组,差异有统计学意义(P<0.01);中药组治疗后颈动脉内膜中层厚度低于西药组,差异有统计学意义(P<0.01)。结论中药治疗及中西医结合治疗是干预亚临床甲减的有效方法,在降低TSH、改善血脂异常方面具有潜在优势。

Objective To evaluate the clinical efficacy and safety of Chinese herbal prescriptions intervention of subclinical hypothyroidism(SCH).Methods All randomized controlled trials(RCTs)of Chinese herbal prescriptions in treatment of SCH were collected from CNKI,VIP,Wan Fang,PubMed,EmBase and the Cochrane Library with a computer.After selection and data extraction by two researchers independently,researches quality was evaluated,and the data was analyzed with Revman 5.3 software.Results A total of 13 studies with 820 subjects were included.The results of Meta analysis showed that the total clinical efficacy of traditional Chinese medicine and western medicine was compared,and the difference between the two groups was statistically significant(P<0.05).The clinical efficacy comparison of traditional Chinese medicine combined with western medicine and western medicine was statistically significant(P<0.01).Thyroid stimulating hormone(TSH)levels after treatment with traditional Chinese medicine combined with western medicine and western medicine were lower than the western medicine group,the difference was statistically significant(P<0.05).The total cholesterol(TC)level after intervention of Chinese medicine was lower than western medicine treatment,the difference was statistically significant(P<0.01).The carotid artery intima-media thickness(CIMT)after treatment in the Chinese medicine group was lower than that in the western medicine group,and the difference was statistically significant(P<0.01).Conclusion Traditional Chinese medicine and integrated treatment of traditional Chinese and Western medicine are effective methods to cure subclinical hypothyroidism,which have potential advantages in reducing TSH level and improving dyslipidemia.