摘要
目的系统评价中西医结合治疗免疫性血小板减少症(ITP)的疗效。方法计算机检索PubMed、EMBASE、万方数据全文数据库、中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊数据库,对搜集到的临床随机对照试验进行方法学质量评估,并采用RevMan5.1.7软件进行Meta分析。结果共纳入22个研究,合计1527例患者。Meta分析结果显示,中西医结合治疗ITP总有效率较单纯西药治疗优势明显[RR=1.23,95%可信区间为(1.17,1.29),P<0.000 01],漏斗图图形显示发表性偏倚较小。同时,可增加ITP患者外周血小板计数以及骨髓产板巨核细胞数值,远期疗效具有明显优势,不良反应减少。结论现有的有限证据表明,中西医结合疗法治疗ITP临床疗效较单纯西医治疗效果好。受纳入研究文献的数量和质量限制,欲得出更加可靠的结论,还有待进行设计严谨的大样本、多中心、随机双盲对照试验。
Objective To evaluate the clinical efficacy of integration of traditional Chinese and western medicine （ITWM） or pure western medicine on the patients with immune thrombocytopenia （ITP）. Methods Randomized controlled trials （RCTs） on ITWM treatment of ITP were searched in PubMed, EMBASE, Wanfang database, CBMDisc, CNKI and VIP. Quality of the RCTs was evaluated strictly, and statistical analysis was performed with Cochrane Collaboration’s RevMan5.1.7 software. Results Twenty-two trials involving 1527 patients were included. The results of Meta-analysis showed that the ITWM treatment of ITP significantly improved the total effective rate [RR=1.23, 95%CI （1.17, 1.29）, P〈0.000 01] compared with that of pure western medicine treatment. Funnel plot showed that publication bias was small. Meanwhile, peripheral platelet count and the number of megakaryocyte which can generate platelet in bone marrow increased, obvious advantage was showed in long-term effect, and adverse reactions were reduced with ITWM treatment in ITP patients. Conclusion The existed limited evidences suggest that ITWM treatment of ITP can significantly improve clinical efficacy. The quantity and quality of research literature were limited, and well-designed randomized double-blind controlled trials with large sample and multi-centers are required for a more reliable conclusion.
出处
《中国中医药信息杂志》
CAS
CSCD
2014年第3期5-9,共5页
Chinese Journal of Information on Traditional Chinese Medicine
基金
湖南省研究生科研创新项目基金(CX2012B340)
关键词
免疫性血小板减少症
中西医结合治疗
临床疗效
META分析
immune thrombocytopenia
integration of traditional and western medicine
clinical efficacy
Meta-analysis
