从肝论治寻常型银屑病伴焦虑抑郁Meta分析

Meta-analysis of resolving superficies method in the treatment of psoriasis vulgaris

目的:系统评价从肝论治寻常型银屑病伴焦虑抑郁的效果与安全性。方法:搜集建库以来针对寻常型银屑病从肝论治的随机对照研究(RCT),由2名研究者独立筛选文献、提取资料和评价偏倚风险,采用Rev Man 5.4软件进行合并分析。主要分析指标为总有效率、银屑病面积与严重性指数(PASI评分)、SAS评分、SDS评分、HAMD评分、不良反应发生率等。结果:共纳入8个RCT,共计738例患者。Meta分析结果显示从肝论治较其他治疗方式在提高临床总有效率[RR=1.23,95%CI(1.12,1.35),P<0.00001]、降低PASI评分[MD=-1.30,95%CI(-1.65,-0.95),P<0.00001]、减低SAS、SDS、HAMD评分[SAS:MD=-7.36,95%CI(-12.12,-2.61),P=0.002;SDS:MD=-7.67,95%CI(-13.26,-2.08),P=0.007;HAMD:MD=-4.85,95%CI(-6.05,-3.65),P<0.00001]、降低不良反应发生率[RR=0.33,95%CI(0.16,0.70),P=0.004]方面差异显著,具有统计学意义。结论:从肝论治寻常型银屑病伴焦虑抑郁有较好的临床疗效与安全性。但本研究纳入文献数据质量偏低,样本量不足,今后需开展更多高质量、大样本研究,对从肝论治寻常型银屑病伴焦虑抑郁的疗效优势进一步验证。

Objective:To systematically evaluate the efficacy and safety of treating psoriasis vulgaris with anxiety and depression from liver.Methods:Randomized controlled trials(RCTs)on the treatment of psoriasis vulgaris from liver were collected.Two reviewers independently screened literature,extracted data and assessed risk of bias.Rev Man 5.4 software was used for Meta-analysis.The main analysis indexes were:total effective rate,psoriasis area and severity index(PASI score),Zung Self-Rating Anxiety Scale(SAS score),Self-rating Depression Scale(SDS score),Hamilton Depression Scale(HAMD score),incidence of adverse reactions,etc.Results:A total of 8 RCTs involving 738 patients were included.The results of Meta-analysis showed that the application of treatment from the liver compared with other treatment methods improved the clinical effective rate[RR=1.23,95%CI(1.12,1.35),P<0.00001],and decreased the PASI score[MD=-1.30,95%CI(-1.65,-0.95),P<0.00001],reduced SAS,SDS,HAMD score[SAS:MD=-7.36,95%CI(-12.12,-2.61),P=0.002;SDS:MD=-7.67,95%CI(-13.26,-2.08),P=0.007;HAMD:MD=-4.85,95%CI(-6.05,-3.65),P<0.00001],reduced incidence of adverse reactions[RR=0.33,95%CI(0.16,0.70),P=0.004],the difference was statistically significant.Concludion:There is a good clinical efficacy and safety from the anxiety depression from the constant type of psoriasis from the liver theory.However,this study is included in the low quality of literature,the amount of sample is insufficient.In the future,more high-quality and large-sample studies are needed to further scientifically verify the therapeutic advantages of treating psoriasis vulgaris with anxiety and depression from the liver.