中西医结合治疗多发性硬化的Meta分析

Meta Analysis of Integrated Traditional Chinese and Western Medicine in the Treatment of Multiple Sclerosis

目的 评价中西医治疗多发性硬化(Multiplesclerosis,MS)的有效性和安全性。方法 计算机检索各数据库(中国知网、万方、维普、PubMed),收集中西医联合治疗MS的随机对照试验,检索时间从2010年1月—2022年12月,两位研究员根据标准筛选文献,然后提取相关信息,使用Rev Man 5.4软件评估文献质量偏差和风险以及各结局指标Meta分析。结果 纳入15篇文献,共计1072例患者,治疗组563例,对照组509例。Meta分析结果显示:与对照组治疗比较,EDSS评分[MD=-0.72,95%CI(-1.20,-0.25)],临床症状评分[MD=-2.64,95%CI(-3.22,-2.06)],神经功能体征评分[MD=-1.48,95%CI(-1.95,-1.01)],有效率[OR=4.38,95%CI(2.93,6.56)],复发次数[MD=-0.59,95%CI(-0.70,-0.47)]。结论 中西医结合治疗MS的临床疗效优于单纯的西医疗法,并且能减少激素带来的副作用、降低复发次数,然而,目前可供参考的文献较为有限且质量有待提高,因此仍需要进行大样本、高质量的临床研究以确认相关结论。

Objective To analyze the efficacy and safety of traditional Chinese and western medicine in the treatment of multiple sclerosis.Methods The databases(CNKI,Wanfang,VIP,PubMed)were searched by computer to collect randomized controlled trials of combined traditional Chinese and western medicine in the treatment of multiple sclerosis from January 2010 to December 2022.Two researchers independently screened the literature according to the inclusion and exclusion criteria.They extracted the data and evaluated the risk of literature quality bias and meta-analysis of each outcome index by Rev Man 5.4 software.Results A total of 15 articles were included,involving 1072 patients,563 in the treatment group and 509 in the control group.The results of meta-analysis showed that compared with the control group,EDSS score[MD=-0.72,95%CI(-1.20,-0.25)],clinical symptom score[MD=-2.64,95%CI(-3.22,-2.06)],neurological function score[MD=-1.48,95%CI(-1.95,-1.01)],effective rate[OR=4.38,95%CI(2.93,6.56)],recurrence frequency[MD=-0.59,95%CI(-0.70,-0.47)].Conclusion The current clinical research evidence indicates that the clinical efficacy of integrated traditional Chinese and western medicine in the treatment of multiple sclerosis is better than that of western medicine alone.Additionally,integrated traditional Chinese and western medicine can reduce the side effects caused by hormones and reduce the number of recurrences.Nonetheless,validating the assertions will require extensive research with sizeable and high-quality clinical samples,as current literature on the subject is scarce and of inferior quality.