白芍总苷联用甲氨蝶呤治疗幼年特发性关节炎的Meta分析

摘要

目的：系统评价白芍总苷（ TGP）联用甲氨蝶呤（ MTX）治疗幼年特发性关节炎（ JIA）的临床疗效及安全性，为临床用药提供证据。方法计算机检索 Pubmed、CNKI、VIP数据库1989年9月—2014年9月有关TGP联用MTX治疗JIA的随机对照试验（ RCT），按照纳入与排除标准筛选出符合要求的RCT，采用RevMan 5．0版软件进行系统评价。结果共纳入4个RCT，合计237例患者，其中试验组120例，对照组117例。 Meta分析结果显示：治疗12周后，TGP联用MTX治疗与单用MTX治疗的总有效率比较差异无统计学意义[ OR＝3．75、95％CI（0．63，22．36），P＝0．15]；而治疗24周后总有效率比较差异有统计学意义[OR＝2．03，95％CI（1．04，9．11），P＝0．04]。结论 TGP联用MTX治疗JIA较单用MTX治疗能够提高总有效率，一定程度上减轻主要不良反应，从而起到增效减毒的作用。%Objective It is to get medication proves though the systemic assessment on the clinical efficacy and safety of the total glucosides paeony ( TGP) combined with methorexate ( MTX) in the treatment for juvenile idiopathic arthritis ( JIA) . Mte hods The PubMed, CNKI and VIP database (Sep, 1989-Sep, 2014) were retrieved for the randomized controlled trials ( RCT) of treating JIA by TGP combined with MTX , and then screen out the satisfactory RCT though inclusion and exclusion criteria, which was systematically assessed by RevMan 5.0 software.Results 4 RCT with 237 patients of which 120 in experi-mental group while 117 in control group were totally screened .The results of Meta analysis showed that:12 weeks later, the efficiency variance between the treatment of TGP combined with MTX and MTX only had no statistical significance [ OR=3.75, 95%CI (0.63, 22.36), P=0.15], while it had statistical significance after 24 weeks[OR=2.03,95%CI (1.04,9. 11), P=0.04].Conclusion The treatment of TGP combined with MTX could improve the total efficiency compared with the treatment of MTX only , it could also relieve the adverse reaction partly and strengthen the its effect of reducing toxicity .