摘要
背景:研究资料显示雷公藤多苷单用治疗类风湿关节炎的疗效与甲氨蝶呤相当,雷公藤多苷联合甲氨蝶呤片治疗类风湿性关节炎的临床效果较好。目的:系统评价雷公藤多苷联合甲氨蝶呤治疗类风湿关节炎的疗效,为临床提供循证参考。方法:计算机检索PubMed、Cochrane图书馆、中国知网、万方数据和中国生物医学文献数据库,检索时限为建库起至2018-12-31,收集雷公藤多苷联合甲氨蝶呤治疗(实验组)对比甲氨蝶呤治疗(对照组)类风湿关节炎的临床试验资料,采用Cochrane系统评价对文章进行质量评估,RevMan5.3软件对共纳入的10项研究结果的总体效应进行Meta分析。结果与结论:①Meta分析结果显示:晨僵时间、关节肿痛、关节压痛数、关节肿胀数、红细胞沉降率、C-反应蛋白、类风湿因子及不良反应发生率实验组均低于对照组,差异显著性意义。晨僵时间[SMD=-1.51,95%CI(-2.31,-0.71),P=0.0002];关节肿痛[SMD=-1.50,95%CI(-2.66,-0.35),P=0.001];关节压痛数[SMD=-1.28,95%CI(-1.98,-0.57),P=0.0004];关节肿胀数[SMD=-1.46,95%CI(-2.48,-0.44),P=0.005],红细胞沉降率[SMD=-1.86,95%CI(-2.90,-0.83),P=0.0004];C-反应蛋白[SMD=-1.50,95%CI(-2.40,-0.60),P=0.001];类风湿因子[SMD=-1.11,95%CI(-1.96,-0.26),P=0.01];不良反应发生率[RR=0.67,95%CI(0.48,0.93),P=0.002];②临床总有效率实验组明显优于对照组[RR=1.23,95%CI(1.13,1.35),P<0.00001];③结果说明,雷公藤多苷联合甲氨蝶呤治疗类风湿关节炎可提高有效率,改善类风湿关节炎相关的各项体征及症状,降低了药物毒副作用,具有良好的安全性。
BACKGROUND: The efficacy of tripterygium glycosides is equal to the methotrexate in the treatment of rheumatoid arthritis, and the clinical efficacy of the combination of tripterygium glycosides and methotrexate is better. OBJECTIVE: To systematically evaluate the efficacy of tripterygium glycosides combined with methotrexate in the treatment of rheumatoid arthritis, so as to provide evidence-based reference for clinical practice. METHODS: PubMed, The Cochrane Library, CNKI, WanFang and SinoMed databases were searched from database establishment time to December 31, 2018. The clinical trial data of tripterygium glycosides combined with methotrexate(trial group) and methotrexate(control group) in the treatment of rheumatoid arthritis were collected. The Cochrane system was used to evaluate the quality of the literature. RevMan 5.3 software was used to conduct a meta-analysis of the overall effects of 10 studies. RESULTS AND CONCLUSION:(1) Meta-analysis results showed that: morning stiffness [SMD=-1.51, 95%CI(-2.31,-0.71), P=0.000 2], joint swollen and pain [SMD=-1.50, 95%CI(-2.66,-0.35), P=0.001], joint pressure pain [SMD=-1.28, 95%CI(-1.98,-0.57), P=0.000 4], joint swelling [SMD=-1.46, 95%CI(-2.48,-0.44), P=0.005], erythorcyte sedimentation rate [SMD=-1.86, 95%CI(-2.90,-0.83), P=0.000 4], C-reactive protein [SMD=-1.50, 95%CI(-2.40,-0.60), P=0.001], rheumatoid factor [SMD=-1.11, 95%CI(-1.96,-0.26), P=0.01], and incidence of adverse reaction [RR=0.67, 95%CI(0.48, 0.93), P=0.002] in the trial group was significantly lower than that in the control group.(2) The total effective rate in the trial group was significantly better than that in the control group [RR=1.23, 95%CI(1.13, 1.35), P < 0.000 01].(3) These results indicate that tripterygium glycosides combined with methotrexate in the treatment of rheumatoid arthritis can elevate the efficiency, improve the various signs and symptoms associated with rheumatoid arthritis, reduce the side effects of drugs, and have good safety.
作者
尹聪
陈鑫
孙辉
于啊香
袁丽君
佟智斌
成引杰
涂星
Yin Cong;Chen Xin;Sun Hui;Yu Axiang;Yuan Lijun;Tong Zhibin;Cheng Yinjie;Tu Xing(Department of Medicine, Hubei Minzu University, Enshi 445000, Hubei Province, China)
出处
《中国组织工程研究》
CAS
北大核心
2019年第35期5710-5717,共8页
Chinese Journal of Tissue Engineering Research
基金
湖北省大学生创新创业计划(201810517044)，项目负责人：尹聪
湖北省教育科学规划重点课题(2016GA024)，项目负责人：涂星
国家级大学生创新创业计划(201810517006X)，项目负责人：于啊香~~
关键词
雷公藤多苷
甲氨蝶呤
类风湿关节炎
晨僵
红细胞沉降率
C-反应蛋白
类风湿因子
META分析
tripterygium glycosides
methotrexate
rheumatoid arthritis
morning stiffness
erythorcyte sedimentation rate
C-reactive protein
rheumatoid factor
meta-analysis
作者简介
尹聪,男,1997年生,湖北省长阳县人,土家族,2019年湖北民族大学毕业,主要从事临床药学研究;通讯作者:涂星,博士,硕士生导师,讲师,湖北民族大学医学部,湖北省恩施市445000.
