摘要
[目的]系统评价补中益气汤治疗重症肌无力(MG)的有效性和安全性.[方法]计算机检索中国知网(CNKI)、万方(Wanfang)、中国生物医学文献数据库(CBM)、维普(VIP)、PubMed、the Cochrane Library、Web of Science及Embase等国内外主要医学数据库中有关补中益气汤加减单用或联用常规西药(试验组)vs常规西药(对照组)治疗重症肌无力的临床随机对照试验.按照纳入与排除标准,两名研究者独立对文献进行筛选、信息提取及质量评价,运用RevMan 5.3软件进行Meta分析.[结果]共纳入19个研究,涉及1182例患者.Meta分析结果显示,与对照组比较,补中益气汤可显著提高MG患者的临床总有效率(OR=3.85,95%CI[2.77,5.35],P<0.00001)和临床治愈率(OR=3.41,95%CI[2.52,4.60],P<0.00001),改善MG患者的临床绝对评分(MD=1.65,95%CI[0.44,2.85],P=0.008)及中医症候评分(MD=2.30,95%CI[1.35,3.25],P<0.00001),降低MG患者血清乙酰胆碱受体抗体(AChR-Ab)水平(MD=0.66,95%CI[0.04,0.08],P=0.03).补中益气汤加减联用常规西药治疗MG的不良事件发生率低于对照组,2组比较差异有统计学意义(P<0.05).[结论]补中益气汤治疗重症肌无力具有较好的有效性,且不良反应也较少,但鉴于纳入试验的总体质量一般,其有效性和安全性尚需设计严谨的高质量随机对照试验加以证实.
Objective To systematically review the efficacy and safety of Buzhong Yiqi Decoction in treating myasthenia gravis(MG).Methods Computer retrieval was carried out in the primary domestic and oversea databases of CNKI,Wanfang,CBM,VIP,PubMed,the Cochrane Library,and Embase for collecting randomized controlled trials(RCTs)of MG treated with Buzhong Yiqi Decoction alone or together with conventional western medicine(trial group)vs conventional western medicine(control group).According to the inclusion and exclusion criteria,two researchers performed the literature screening,data extract and methodological quality assessment independently.And the meta-analysis was conducted by using RevMan 5.3 software.Results A total of 19 studies were included,involving 1182 MG patients.The results of Meta-analysis showed that in comparison with the control group,Buzhong Yiqi Decoction can enhance the clinical total effective rate(OR=3.85,95%CI[2.77,5.35],P<0.00001)and clinical cure rate(OR=3.41,95%CI[2.52,4.60],P<0.00001),improve the clinical absolute scores(MD=1.65,95%CI[0.44,2.85],P=0.008)and the scores of traditional Chinese medicine symptom manifestations(MD=2.30,95%CI[1.35,3.25],P<0.00001),and decrease the serum level of acetylcholine receptor antibody(AChR-Ab)in MG patients(MD=0.66,95%CI[0.04,0.08],P=0.03).The combination of Buzhong Yiqi Decoction with conventional western medicine reduced the incidence of adverse events,and the difference was statistically significant(P<0.05).Conclusion Buzhong Yiqi Decoction has stronger effect in the treatment of MG with less adverse reaction.However,due to the low overall quality of included studies,the above conclusion still need to be further verified by high-quality randomized controlled trials with rigorous scientific design.
作者
陈秒旬
陈舸
郑耿东
黄丽娜
陈瑞芳
CHEN Miao-Xun;CHEN Ge;ZHENG Geng-Dong;HUANG Li-Na;CHEN Rui-Fang(The First Clinical Medical School of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;School of Public Health,Guangdong Pharmaceutical University,Guangzhou 510310 Guangdong,China;Disease Prevention Department,the First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)
出处
《广州中医药大学学报》
CAS
2019年第11期1861-1870,共10页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
广东省中医药局课题（编号：20164012)
