中西医结合治疗伏格特-小柳-原田综合征临床疗效的Meta分析

目的通过Meta分析系统评价中西医联合治疗伏格特-小柳-原田综合征(Vogt-Koyanagi-Harada syndrome,VKH综合征)的临床疗效。方法根据主题词检索中国知网(CNKI)、万方数据库、中国生物医学文献数据库以及美国国立医学图书馆等数据库中关于中西医联合治疗VKH综合征的中、英文文献。根据纳入与排除的标准以及参照改良后的JADAD量表对所检索的文献进行资料提取与质量的评价,并采用RevMan5.3软件对中西医联合治疗VKH综合征的疗效进行Meta分析。结果共纳入符合条件的文献8篇,共包含540例病例(1056只患眼),其中,治疗组288例(563只患眼),对照组252例(493只患眼)。比较了VKH综合征患者治疗组与对照组的以下临床指标:总有效率(OR=3.81,95%可信区间:[1.88,7.71])、复发率(OR=0.33,95%可信区间:[0.20,0.55])、治疗后视力变化(SMD=0.57,95%可信区间:[0.34,0.81])以及并发症发生率(OR=0.16,95%可信区间:[0.04,0.57])。结论与单纯西药治疗相比,中西医联合治疗VKH综合征具有有效率高、复发率低、视力改善更优以及并发症发生率低的优点。

Meta-Analysis of Clinical Effect of Integrated Traditional Chinese and Western Medicine in Treating Vogt-Koyanagi-Harada Syndrome

Objective To systematically evaluate the clinical efficacy of combined traditional Chinese and western medicine in the treatment of Vogt-Koyanagi-Harada(VKH)syndrome through meta-analysis.Methods The Chinese and English literature on the therapies of VKH syndrome by combination of traditional Chinese and western medicine were retrieved in CNKI database,Wanfang database,CBM database and PubMed database.According to the inclusion criteria,exclusion criteria and modified JADAD Manual,the data of the screened literature was extracted and the quality of screened literature was evaluated.The meta-analysis of the studies involved was carried out by Review Manager 5.3 software to compare the clinical outcome of combination of traditional Chinese and western medicine on the therapies of VKH syndrome.Results A total of 8 eligible trials were involved,including 540 patients(1056 eyes),with 288 patients(563 eyes)in the treatment group and 252 patients(493 eyes)in the control group.The efficacy index of VKH syndrome patients in the treatment group was compared with that in the control group:total effective rate(OR=3.81,95%CI:[1.88,7.71]),relapse rate(OR=0.33,95%CI:[0.20,0.55]),visual acuity changes(SMD=0.57,95%CI:[0.34,0.81]),complication rate(OR=0.16,95%CI:[0.04,0.57]).Conclusion Combined Chinese and western medicine in the treatment of VKH syndrome has obvious superiority over western medicine treatment alone,because of high clinical total effective rate,low relapse rate and better visual acuity changes and low complication rate.