中成药临床证据分析报告(2020年)

Clinical evidence analysis report of Chinese patent medicine in 2020

收集、整理、分析和评价2020年发表在中、英文期刊的中成药随机对照试验(randomized controlled trial, RCT),对中成药临床证据进行阶段性总结,为后续临床研究的开展、证据转化应用提供参考。基于中医药循证研究证据库系统(EVDS)旗下中成药临床证据数据库的收录,并补充检索中国知网(CNKI)、万方(Wanfang)、中国生物医学文献服务系统(SinoMed)、Cochrane Library、PubMed、EMbase数据库,全面获取2020年发表的中成药RCTs,对其研究特征和方法学质量进行分析、评价。共纳入文献1 285篇[中文1 257篇,英文28篇(包括10篇试验设计方案)],包括146 054例患者,覆盖639种中成药(口服中成药526种,注射剂68种,外用中成药45种),涉及疾病类型23类,病种412种,研究热点疾病为循环系统和呼吸系统疾病,热点病种为脑梗死、心绞痛。研究规模方面,纳入研究样本量最少20例,最多2 673例,57.67%的研究样本量少于100例;病例来源以单中心研究为主,多中心研究仅占4.75%(61篇)。方法学方面,52.91%的研究存在随机方法描述不清或者应用错误的情况,分配隐藏、盲法的实施仍未被重视。总体而言,与2019年相比,2020年RCTs发文量有所下降,呼吸系统类疾病的研究热度上升,研究设计和实施过程中的质量控制仍未改善,需加强研究者方法学培训及试验质量控制,重视高质量研究证据的产出。

The present study collected, collated, analyzed, and evaluated randomized controlled trial(RCT) of Chinese patent medicine published in Chinese and English journals in 2020, and summarized clinical evidence of Chinese patent medicine in stages, providing references for follow-up clinical research and evidence transformation and application. On the basis of the collection in the Traditional Chinese Medicine(TCM) Clinical Evidence Database System(EVDS), CNKI, Wanfang, SinoMed, Cochrane Library, PubMed, and EMbase were searched for RCTs of Chinese patent medicine published in 2020, and their research characteristics and methodological quality were analyzed and evaluated. A total of 1 285 research papers on Chinese patent medicine(1 257 in Chinese/28 in English) were included, involving 146 054 patients and 639 Chinese patent medicines, including 526 oral drugs, 68 injections, and 45 external drugs. A total of 412 diseases in 23 types were involved, which were dominated by circulatory system diseases and respiratory system diseases, specifically, cerebral infarction and angina pectoris. The sample size ranged from 20 cases to 2 673 cases, and 57.67% of RCTs had samples sizes less than 100. Single-center trials were the main ones, and multi-center trials only accounted for 4.75%(n=61). In terms of methodological quality, 52.91% of the RCTs had unclear descriptions or incorrect application of randomization methods, and the implementation of allocation concealment and blinding methods has not been paid much attention. In conclusion, compared with the conditions in 2019, the number of RCTs published in 2020 has decreased, and the research interest in respiratory diseases has increased, while the quality control in the process of research design and implementation has not been improved. Therefore, it is necessary to strengthen the methodological training of researchers and promote the output of high-quality research evidence.