中西医结合治疗类风湿关节炎疗效的Meta分析

摘要

Objective: To study the curative effects of combined Chinese and Western medicine in the treatment of rheumatoid arthritis (RA) and provide evidence to optimize the RA therapeutic regimen. Methods: The word for "类风湿 关节炎", "历节", "久痹", "尪痹", "rheumatoid arthritis", "arthritis" and "rheumatic diseases" were searched in full-text database such as Chongqing VIP, CNKI, WANFANG, Chinese Medical Citation Index (integrated version of CMCI/CMCC), MEDLINE, ScienceDirect and SpringerLink. Randomized controlled trials of combined Chinese and Western medicine for the treatment of RA were taken as the study object. The latest version of Revman 5.0 software provided by the Cochrane Collaboration was used for statistical analysis. The odds ratios were used as the indicator of combined effects. Results: A total of 12 articles were included in the study. The total effective number of the treatment group and the control group were 488/540 (90.37％) and 354/475 (74.52％) respectively. The OR value was 3.33, 95％CI were 2.32, 4.76, the overall effect test Z=6.57, P<0.000 01. Conclusion: The combined Chinese and Western medicine is more effective than Western medicine alone in the treatment of RA. It has significantly reduced the side effects compared to Western medicine alone and increased drug tolerance.%目的:探讨中西医结合治疗类风湿关节炎(rheumatoid arthritis,RA)的疗效,为中西医结合治疗RA方案的优化提供佐证.方法:以"类风湿关节炎"、"历节"、"久痹"、"尪痹"及"rheumatoid arthritis"、"arthritis"、"rheumatic diseases"为检索词,从重庆维普库(VIP)、中国期刊全文数据库(CNKI)、万方数据库(WANFANG)、中国生物医学期刊引文数据库(CMCI/CMCC整合版)以及MEDLINE、ScienceDirect、SpringerLink等全文数据库中检索,以中西医结合治疗RA的随机对照试验为研究对象,采用Cochrane协作网提供的最新版Revman 5.0软件进行统计分析,采用优势比作为效应合并指标.结果:共12篇文献纳入研究,治疗组和对照组的总有效人数分别为488/540(90.37%)和354/475(74.52%).OR值为3.33,95%CI为2.32、4.76,整体效果检验Z=6.57(P<0.000 01).结论:中西医结合治疗RA的疗效优于单纯西药治疗,且明显减轻了单纯西药治疗的毒副作用,增强了用药的耐受性.