摘要
目的系统评价白虎加桂枝汤治疗痛风的有效性与安全性。方法计算机检索国内外5个数据库(CNKI,VIP,WanFang,CBM,PubMed),搜索时间从建库至2020年4月,收集白虎加桂枝汤治疗痛风的随机对照研究。2名研究者按照纳排标准独立进行筛选文献、资料提取和质量评价。采用RevMan5.3对数据进行Meta分析。结果最终纳入8项研究,共纳入研究对象797例,其中治疗组399例,对照组398例。Meta分析结果显示白虎加桂枝汤治疗急性痛风性关节炎有效率明显优于对照组(RR=3.24,95%CI[1.92,5.49],P<0.0001);在降低血尿酸水平方面,优于降尿酸治疗组(WMD=-10.74,95%CI[-20.18,-1.30],P=0.03)和秋水仙碱组(WMD=-67.35,95%CI[-68.56,-66.14],P<0.0001);在降低CRP(WMD=-3.26,95%CI[-6.31,-0.22],P=0.04)和ESR(WMD=-5.97,95%CI[-9.99,-1.95],P=0.004)方面白虎加桂枝汤对比对照组有明显优势。在安全性方面,白虎加桂枝汤治疗组不良反应发生率明显低于对照组(RR=0.22,95%CI[0.13,0.39],P<0.00001)。结论白虎加桂枝汤治疗急性痛风性关节炎可明显改善临床相关症状和相关指标,具有明显疗效,且不良反应发生率低,但仍需要开展高质量、多中心、大样本研究进一步提升临床证据。
Objective:To evaluate the clinical efficacy and safety of Baihu Jiaguizhi Decoction in the treatment of gout.Methods:Databases of CNKI,VIP,WanFang,CBM,PubMed were systematically retrieved from inception to April 2020 for randomized controlled trials of Baihu Jiaguizhi Decoction in treating gout.Two researchers independently searched,screened and extracted data according to inclusion and exclusion criteria.Meta-analysis was performed using RevMan 5.3.Results:A total of 8 studies involving 797 patients were included,399 cases in the trial group,398 cases in the control group.Meta-analysis showed that the efficacy of Baihu Jiaguizhi Decoction in the treatment of gout was better than that of the control group[RR=1.10,95%CI(1.03,1.17)].In the lower blood uric acid levels,it was better than the blood uric acid treatment group(WMD=-10.74,95%CI[-20.18,-1.30],P=0.03)and the colchicine group(WMD=-67.35,95%CI[-68.56,-66.14],P<0.0001)In the decrease of the creactive protein(WMD=-3.26,95%CI[-6.31,-0.22],P=0.04)and erythrocyte sedimentation rate(WMD=-5.97,95%CI[-9.99,-1.95],P=0.004),Baihu Jiaguizhi Decoction had better effect as the control group.In safety,the rate of adverse drug reaction using Baihu Jiaguizhi Decoction was less than that of the control group(RR=0.22,95%CI[0.13,0.39],P<0.00001).Conclusion:Baihu Jiaguizhi Decoction for gout can improve clinical symptoms and related indicators,and has less adverse reactions.However,but it still needs the support of high-quality,multicenter,large-sample-size clinical trials to further improve the clinical evidence.
作者
李培豪
王爱华
赵龙梅
张淑敏
刘维
Li Peihao;Wang Aihua;Zhao Longmei;Zhang Shumin;Liu Wei(First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300193,China)
出处
《中国中医急症》
2021年第10期1705-1709,共5页
Journal of Emergency in Traditional Chinese Medicine
基金
国家自然科学基金面上项目(81673927,82074377)
中医药传承与创新“百千万”人才工程(岐黄工程)岐黄学者。
作者简介
通信作者:刘维,电子邮箱:fengshiliuwei@163.com。
