白芍总苷治疗强直性脊柱炎的Meta分析

目的:对白芍总苷(TGP)治疗强直性脊柱炎(AS)的疗效及安全性进行系统评价。方法:使用循证医学方法进行文献分析。计算机检索中国期刊全文数据库、中文科技期刊全文数据库及PubMed数据库中所有有关TGP治疗AS的随机对照实验的文献,对纳入研究进行评价筛选并提取数据。使用Rev Man 5.0软件进行Meta分析。结果:共有11例随机对照实验,合计692例患者入选。与对照组比较,TGP治疗组总有效率明显升高[OR=3.36,95%CI(2.03,5.54),P<0.01],而不良反应发生率明显降低[OR=0.34,95%CI(0.21,0.53),P<0.01];在改善C反应蛋白及Bath AS病情活动指数方面,TGP治疗组优于对照组,Meta分析结果分别为[均数差(MD)=-6.07,95%CI(-9.44,-2.70),P<0.01]和[MD=-2.66,95%CI(-5.16,-0.15),P<0.05];在改善红细胞沉降率及Bath AS功能指数方面,2组差异均无统计学意义,Meta分析结果分别为[MD=-2.20,95%CI(-9.52,5.12),P>0.05]和[MD=-7.50,95%CI(-21.31,6.31),P>0.05]。结论:TGP治疗AS可显著增加临床治疗有效率并降低不良反应发生率。

Meta-analysis of therapeutic effects of total glucosides of paeony for ankylosing spondylitis

Objective:To analyze the therapeutic effects of total glucosides of paeony ( TGP ) for ankylosing spondylitis ( AS ) . Methods:By literature analysis based on evidence-based medicine,randomized controlled trials about TGP in the treatment of AS were obtained from Chine National Knowledge infrastructure,VIP and PubMed. Evaluated the quality of included studies and extracted the data. Rev Man 5. 0 software was used for Meta analysis. Results:Eleven randomized controlled trials with a total of 692 patients were included. Results of meta-analysis showed that the total effective rate of TGP group was higher than that of control group, and the difference was statistically significant[OR=3. 36,95%CI(2. 03,5. 54),P<0. 01]. As to the adverse reaction,the TGP group has a rather lower incidence than that of control group,and the difference was statistically significant[OR=0. 34,95%CI(0. 21,0. 53),P<0. 01]. At the same time,statistical significances were found in reducing C-reactive protein and Bath ankylosing spondylitis disease activity index between these two groups,result of Meta-analysis is[MD= -6. 07,95%CI( -9. 44,-2. 70),P<0. 01] and[MD=-2. 66,95%CI( -5. 16,-0. 15),P<0. 05] respectively. No statistically difference was found in reducing erythrocyte sedimentation rate and Bath ankylosing spondylitis functional index between these two groups,result of Meta-analysis is[MD = -2. 20,95%CI ( -9. 52,5. 12),P>0. 05] and[MD= -7. 50,95%CI( -21. 31,6. 31),P>0. 05] respectively. Conclusions:TGP can improve clinical efficient and reduce adverse reaction significantly.