薏苡仁汤治疗寒湿痹阻型类风湿关节炎有效性和安全性的Meta分析

Meta-analysis on the Efficacy and Safety of Yiyiren Tang(薏苡仁汤)in the Treatment of Rheumatoid Arthritis of Cold Dampness Obstruction Type

目的:系统评价薏苡仁汤治疗寒湿痹阻型类风湿关节炎的有效性和安全性。方法:运用计算机检索中国知网、万方、维普、中国生物医学文献服务系统、PubMed、Medline、Cochrane library、Embase数据库;并手工检索纳入文献的参考文献、相关学位论文和会议论文集。检索时间为数据库建立至2019年4月。由2名研究人员分别独立进行文献的检索和筛选工作,各自独立依据Jadad评分量表对纳入的研究进行质量评价和数据的提取工作,采用RevMan 5.3软件进行Meta分析。结果:纳入11篇随机对照文献,共797例患者,其中治疗组399例,对照组398例;3分文献4篇,其余文献均为1~2分。治疗组总有效率高于对照组(OR=3.57,95%CI=[2.24,5.69],P<0.00001);红细胞沉降率(MD=-5.91,95%CI=[-9.23,-2.59],P=0.0005),C反应蛋白(MD=-3.65,95%CI=[-4.44,-2.86],P<0.00001),关节压痛数(MD=-2.47,95%CI=[-3.61,-1.32],P<0.0001),关节肿胀数(MD=-1.24,95%CI=[-2.12,-0.37],P=0.005),晨僵时间(MD=-3.45,95%CI=[-4.56,-2.33],P<0.00001),均优于对照组。2组治疗后药物不良反应及类风湿因子水平比较,差异无统计学意义(P>0.05)。结论:薏苡仁汤治疗寒湿痹阻型类风湿关节炎效果显著,值得临床推广应用。

Objective:To systematically evaluate the efficacy and safety of Yiyiren Tang(薏苡仁汤)in the treatment of rheumatoid arthritis of cold dampness obstruction type.Methods:Databases such as CNKI,W anfang,Vip,SinoMed,PubMed,Medline,Cochrane library and Embase were searched,and the references,relevant dissertations and conference papers included in the literature were manually retrieved from the establishment of the databases to April 2019.Two researchers independently searched and screened the literature,independently evaluated the quality of the included studies and extracted the data according to the Jadad score scale,and conducted meta-analysis with the software Revman 5.3.Results:Eleven randomized controlled literatures were included,including 797 patients(399 in the treatment group and 398 in the control group).There were 4 documents with 3 points,and the other documents with 1~2 points.The total effective rate of the treatment group was higher than that of the control group(OR=3.57,95%CI=[2.24,5.69],P<0.00001);the treatment group was better than the control group on the aspects of erythrocyte sedimentation rate(MD=-5.91,95%CI=[-9.23,-2.59],P=0.0005),C-reactive protein(MD=-3.65,95%CI=[-4.44,-2.86],P<0.00001),joint tenderness(MD=-2.47,95%CI=[-3.61,-1.32],P<0.0001),and joint swelling(MD=-1.24,95%CI=[-2.12,-0.37],P=0.005),morning stiffness(MD=-3.45,95%CI=[-4.56,-2.33],P<0.00001).There were no significant differences in adverse reactions and rheumatoid factor levels between the two groups(P>0.05).Conclusion:YiYiren Tang is effective in the treatment of rheumatoid arthritis of cold dampness obstruction type,which is worthy of clinical application.