摘要
使用Meta分析探寻中药健脾法治疗特应性皮炎的临床疗效,计算机检索中国知网（CNKI）、万方数据知识服务平台、维普中文期刊数据库（VIP）、中国生物医学文献数据库（CBM）,Pub Med,Cochrane Library,EMbase数据库,搜索中药健脾法治疗特应性皮炎的随机对照试验,检索时限均为自建库至2017年12月,由2名评价员分别对检索出的文献进行筛选并提取有效数据,使用Cochrane推荐的偏倚风险评估方法评价纳入研究文献的偏倚风险,应用Review Manager 5.3软件进行Meta分析,最终纳入37项随机对照试验,共计2 973例患者。结果显示,中药健脾法与西药相比,临床有效率更高,差异具有统计学意义（OR=4.05,95%CI[3.27,5.03],P〈0.000 01）;评分改善更加明显,包括SCORAD评分（WMD=-9.82,95%CI[-13.31,-6.33],P〈0.000 01）、EASI评分（WMD=-2.80,95%CI[-3.54,-2.07],P〈0.000 01）、瘙痒VAS评分（WMD=-0.79,95%CI[-1.10,-0.47],P〈0.000 01）;血清生化水平改善更加明显,包括IFN-γ（WMD=1.75,95%CI[1.14,2.35],P〈0.000 01）,IL-4（WMD=-3.15,95%CI[-4.16,-2.15],P〈0.000 01）,EOS（WMD=-0.11,95%CI[-0.20,-0.02],P=0.02）;复发率显著降低（OR=0.36,95%CI[0.21,0.60],P〈0.000 1）;纳入研究中有11篇报告了试验相关不良反应。结果表明中药健脾法治疗特应性皮炎临床疗效明显高于西药组,另外由于所纳入的文献存在发表偏倚和低质量偏倚,此结论还需更多的多中心、高质量、大样本、双盲随机对照试验加以论证。
To evaluate the clinical efficacy of traditional Chinese medicine Jianpi therapy in the treatment of atopic dermatitis.CNKI,Wanfang knowledge service platform,VIP journal database,Chinese biomedical literature database（ CBM）,Pub Med,the Cochrane Library and EMbase database from inception to December 2017 were searched for the randomized controlled trials（ RCTs） on traditional Chinese medicine Jianpi therapy in the treatment of atopic dermatitis. Literature selection and information extraction was completed and screened by two independent reviewers,and then the Cochrane recommended bias risk assessment method was used to evaluate the bias risk,and Review Manager 5. 3 was used for the data analysis. Totally 37 clinical RCTs were included in this study,involving 2 973 patients. Analysis results showed that as compared with the western medicine,traditional Chinese medicine Jianpi therapy had higher clinical effective rate,with statistically significant difference（ OR = 4. 05,95% CI[3. 27,5. 03],P 〈 0. 000 01）; the improvement of score was more evident,including SCORAD score（ WMD =-9. 82,95% CI[-13. 31,-6. 33],P 〈 0. 000 01）,EASI score（ WMD =-2. 80,95% CI[-3. 54,-2. 07],P 〈 0. 000 01）,and itching VAS score（ WMD =-0. 79,95% CI[-1. 10,-0. 47],P 〈 0. 000 01）; the improvement of serum biochemical levels was more evident,including interferon-γ（ IFN-γ）（ WMD = 1.75,95% CI[1. 14,2. 35],P 〈 0. 000 01）,interleukin-4（ IL-4）（ WMD =-3. 15,95% CI[-4. 16,-2. 15 ],P 〈 0. 000 01）,and Eosinophil direct count（ EOS）（ WMD =-0. 11,95% CI[-0. 20,-0. 02 ],P = 0. 02）; recurrence rate was significantly reduced（ OR = 0. 36,95% CI[0. 21,0. 60],P 〈 0. 000 1）; and trial-related adverse events were reported in 11 RCTs. Studies have shown that traditional Chinese medicine Jianpi therapy had significantly higher clinical efficacy than western medicine in the treatment of atopic dermatitis. However,due to the publication bias and low quality bias of included RCTs in this study,more mu
作者
刘勇
赵一丁
闫小宁
LIU Yong;ZHAO Yi-ding;YAN Xiao-ning(The First Clinical Medical College of Shaanxi University of Traditional Chinese Medicine, Xianyang 712046, China;Shaanxi Provincial Hospital of Traditional Chinese Medicine, Xi＇an 710004, China)
出处
《中国中药杂志》
CAS
CSCD
北大核心
2018年第9期1922-1933,共12页
China Journal of Chinese Materia Medica
基金
国家自然科学基金项目(81704087)
国家中医临床研究基地拓展病种项目(20160524)
创新人才推进计划-重点科技创新团队计划项目(2017KCT-27)
陕西省临床医学研究中心项目(2016LCZX-12)
