摘要
目的:应用Meta分析评价银屑病患者应用白芍总苷后炎症细胞因子水平的变化及临床疗效,探究白芍总苷有效治疗银屑病的微观作用机制。方法:计算机检索中国知网、万方、维普、中国生物医学文献服务系统、Medline、Embase及Cochrane Library等数据库,检索时间范围自建库起至2020年5月。将检索到的文献进行筛选、数据提取和偏倚风险评估后,应用Revman5.3软件进行统计分析;结果:共纳入11个临床研究,总计患者998例,其中试验组502例,对照组496例。Meta分析结果显示,联合使用白芍总苷组的细胞因子总表达水平与对照组相比,具有统计学差异[MD=−10.97,95%CI(−15.56,−6.37)],同时在治疗有效率[OR=3.57,95%CI(2.58,4.94)]和治疗后PASI评分[MD=−4.55,95%CI(−5.91,−3.20)]方面均优于对照组(P<0.05)。结论:白芍总苷通过抑制银屑病患者血清中IL-2、IL-8、IL-23和TNF-α等细胞因子的表达,从而调控机体免疫与炎症反应、改善皮损情况。鉴于纳入的研究总体质量偏低,仍需要更大样本、更高质量的临床试验以获得更充分的证据。
Objective:To evaluate the relationship between the changes of inflammatory cytokines and clinical efficacy in patients with psoriasis treated with total glucosides of paeony by meta analyses,and to explore the microcosmic mechanism of effective treatment of psoriasis with total glucosides of paeony from the point of view of evidence-based medicine.Methods:The databases of CNKI,Wanfang,VIP,SinoMed,Medline,Embase and Cochrane Library were searched by computer,and the time range was from the incetive of the database to May 2020.After screening,data extraction and bias risk assessment,Revman5.3 software was used for statistical analysis.Results:A total of 998 patients were included in 11 clinical studies,including 502 patients in the trial group and 496 patients in the control group.The results of meta analysis showed that there was significant difference in the expression of cytokines between the two groups[MD=−10.97,95%CI(−15.56,−6.37)].The effective rate of treatment[OR=3.57,95%CI(2.58,4.94)]and PASI score after treatment[MD=−4.55,95%CI(−5.91,−3.20)]in the combined use of Total glucosides of paeony group were superior to those in the control group.Conclusion:Total glucosides of paeony can regulate immune and inflammatory response and improve skin lesions by inhibiting the expression of cytokines such as IL-2,IL-8,IL-23 and TNF-αin serum of patients with psoriasis.In view of the low overall quality of the included studies,larger samples and higher quality clinical trials are still needed to obtain more sufficient evidence.
作者
陈文廷
闫玉红
喻靖傑
陈筱雨
卢传坚
CHEN Wen-ting;YAN Yu-hong;YU Jing-jie;CHEN Xiao-yu;LU Chuan-jian(Guangzhou University of Traditional Chinese Medicine,Guangzhou 510405,China;Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangzhou 510120,China;State Key Laboratory of Dampness Syndrome of Chinese Medicine,Guangzhou 510120,China;Key Laboratory of TCM Syndrome Clinical Research of Guangdong Province,Guangzhou 510120,China)
出处
《海南医学院学报》
CAS
2022年第11期835-841,共7页
Journal of Hainan Medical University
基金
中医湿证国家重点实验室专项(SZ2020ZZ15)。
关键词
银屑病
白芍总苷
细胞因子
随机对照
META分析
Psoriasis
Total glucosides of Paeony
Cytokines
Randomized controlled
Meta-analysis
