摘要
目的:系统评价白虎加桂枝汤加减治疗急性痛风性关节炎的有效性与安全性。方法:计算机检索中国知网(CNKI)、维普(VIP)、万方(Wanfang)、Pubmed、Cochrane Library、Web of Science等数据库发表的白虎加桂枝汤加减治疗急性痛风性关节炎的随机对照试验,检索时间为数据库建立至2019年12月1日。根据Cochrane系统评价手册,采用RevMan 5.3软件对总有效率、血尿酸和不良反应发生率等进行Meta分析。结果:最终纳入12篇文献,共1109例患者,试验组564例,对照组545例。Meta分析结果显示,与常规西药疗法比较,白虎加桂枝汤加减治疗急性痛风性关节炎在总有效率(RR=1.16,95%CI=[1.10,1.23],P<0.00001),血尿酸(MD=-56.01,95%CI=[-75.89,-36.41],P<0.00001)方面疗效显著,不良反应发生率(RR=0.31,95%CI=[0.19,0.49],P<0.00001)更低,差异均有统计学意义。根据GRADE评价标准,总有效率和不良反应发生率2个结局指标证据为中质量,血尿酸变化的结局指标证据为低质量。结论:白虎加桂枝汤加减治疗急性痛风性关节炎有效性和安全性优于西药常规疗法,但此结论仍需要开展多中心、高质量的随机对照试验进一步验证。
Objective:To systematically evaluate the efficacy and safety of Modified Baihu Jia Guizhi Tang(白虎加桂枝汤)in the treatment of acute gouty arthritis.Methods:The randomized controlled trials of treating acute gouty arthritis with Baihu Jia Guizhi Tang collected in CNKI,VIP,Wanfang,PubMed,Coc hrane Library and Web of Science from the establishment of the databases to December 2019 were searched by computer.According to the Cochrane System Review Manual,software Revman 5.3 was used for meta-analysis of the total effective rate,serum uric acid and incidence of adverse reactions.Results:Twelve articles were included,including 1109 patients(564 patients in the experimental group and 545 patients in the control group).Meta-analysis results showed that compared with conventional western medicine therapy,modified Baihu Jia Guizhi Tang had a significant effect on total effective rate(RR=1.16,95%CI=[1.10,1.23],P<0.00001),serum uric acid(MD=-56.01,95%CI=[-75.89,-36.41],P<0.00001)and the incidence of adverse reactions(RR=0.31,95%CI=[0.19,0.49],P<0.00001)was lower,with the difference being statistically significant.According to the GRADE evaluation standard,the total effective rate and the incidence of adverse reactions were of medium quality,and the change of serum uric acid was of low quality.Conclusion:The efficacy and safety of modified Baihu Jia Guizhi Tang in the treatment of acute gouty arthritis is better than that of conventional western medicine,but this conclusion still needs to be further verified by multi-center,high-quality randomized controlled trials.
作者
杨阳
李金田
李娟
李博宽
魏腾飞
田萍
YANG Yang;LI Jin-tian;LI Juan;LI Bo-kuan;WEI Teng-fei;TIAN Ping
出处
《风湿病与关节炎》
2021年第6期23-28,共6页
Rheumatism and Arthritis
基金
国家自然科学基金地区项目(81760836,81460709)。
