芍药甘草汤治疗带状疱疹后遗神经痛的Meta分析

Meta-analysis of Shaoyao Gancao Decoction in the Treatment of Postherpetic Neuralgia

为系统评价芍药甘草汤治疗带状疱疹后遗神经痛的疗效和安全性,使用计算机检索PubMed、EMbase、Cochrane Library、CNKI、Wanfang和VIP等数据库,收集芍药甘草汤治疗带状疱疹后遗神经痛的随机对照试验(RCT),检索时间从建库至2023年05月,并采用RevMan5.3软件进行Meta分析.最终纳入了8项RCT,涉及738名患者.结果显示:与对照组相比,芍药甘草汤组临床有效率[OR=9.08,95%CI(2.74,30.04),P=0.0003]、VAS评分[MD=-1.32,95%CI(-1.88,-0.77),P<0.0001]及PSQI评分[MD=-1.62,95%CI(-1.97,-1.26),P<0.0001]均显著改善,不良事件发生率显著降低[OR=0.36,95%CI(0.2,0.66),P=0.0008].可见,芍药甘草汤可有效缓解带状疱疹后遗神经痛并提高睡眠质量.但鉴于纳入的研究和样本量有限,研究设计质量也尚未随着中医药临床试验规范的发布而明显改善.后续应该实施更多的高质量、大样本的RCT以验证本结论.同时,也需要强化临床试验规范的执行,以进一步提高研究质量.

To systematically evaluate the efficacy and safety of Shaoyao-Gancao Decoction in the treatment of postherpetic neuralgia.Computerized searches were conducted in PubMed,EMbase,Cochrane Library,CNKI,Wanfang,and VIP databases to collect randomized controlled trials(RCTs)on the treatment of postherpetic neuralgia with Shaoyao-Gancao Decoction.The retrieval period ranged from the establishment of the databases to May 2023.Meta-analysis was conducted using RevMan5.3 software.A total of 8 RCTs involving 738 patients were finally included.The results of the meta-analysis showed that compared with the control group,the clinical effective rate[OR=9.08,95%CI(2.74,30.04),P=0.0003],VAS score[MD=-1.32,95%CI(-1.88,-0.77),P<0.0001],and PSQI score[MD=-1.62,95%CI(-1.97,-1.26),P<0.0001]in the Shaoyao Gancao decoction group were significantly improved,accompanied by the significant reduction in the incidence of adverse events[OR=0.36,95%CI(0.2,0.66),P=0.0008].Shaoyao-Gancao Decoction can effectively alleviate postherpetic neuralgia and improve sleep quality.However,considering the limited research and sample size included,and the research design quality has not significantly improved with the publication of traditional Chinese medicine clinical trial norms,more high-quality,large-sample RCTs should be implemented to verify these conclusions.The implementation of clinical trial norms needs to be strengthened to further improve the quality of research.