雷公藤多苷片治疗类风湿关节炎骨破坏的系统评价和Meta分析

Effect of Tripterygium Glycosides Tablets in treating rheumatoid arthritis:a systematic review and Meta-analysis

系统评价雷公藤多苷片治疗类风湿性关节炎(RA)骨破坏的影响,为雷公藤多苷片的临床应用提供循证医学证据。通过计算机与手工检索EMbase,PubMed,Clinical Trials,Web of Science,Cochrane Library,中国知网(CNKI),万方数据库(Wan Fang)、维普数据库(VIP)、中国生物医学文献数据库(CBM)和中国临床试验注册中心(Chi CTR),选择符合纳入标准的文献,按Cochrane系统评价方法,采用Rev Man 5. 3软件对雷公藤多苷片治疗类风湿关节炎患者的手腕部27个关节区骨破坏评分(Sharp)进行分析,对符合纳入标准的临床研究进行资料提取和质量评价后,3篇随机对照试验文献被纳入评价。Meta分析的结果显示,在Van der Heijde改良Sharp评分(m TSS)、关节侵蚀(JE)和关节间隙狭窄(JSN)方面,雷公藤多苷片组均优于对照组中使用的阳性药物甲氨蝶呤(MTX)和柳氮磺吡啶(SSZ),且差异有统计学差异(P<0. 01)。现有临床证据表明,雷公藤多苷片可以有效延缓类风湿关节炎的骨破坏,但由于研究样本量较少,期望将来更高质量大样本随机、对照、双盲试验提供更高级别证据。

To evaluate the effect of Tripterygium Glycosides Tablets extract in the treatment of rheumatoid arthritis(RA).Clinical trials of treating rheumatoid arthritis with Tripterygium Glycosides Tablets published by Meta-analysis were retrieved from EMbase,PubMed,Clinical Trials,Web of Science,Cochrane Library,CNKI,Wanfang,VIP,CBM and Chi CTR,and comprehensively analyzed.A total of 3 studies were enrolled,the modified Sharp score(m TSS),tender join joint erosions(JE)and joint space narrowing(JSN)of Tripterygium Glycosides Tablets group were significant superior to those of control group,including positive drugs methotrexate(MTX)and salazopyridine(SSZ)(P<0.01).Tripterygium Glycosides Tablets had an effect in treating RA.Due to the small sample size,this study shall be verified with high-quality,large-sample-size double-blinded RCTs.