Liu Ya-Fei, Huang Ying, Wen Cai-Yu-Zhu, Zhang Jun-Jun, Xing Guo-Lan, Tu Sheng-Hao, Chen Zhe
Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe East Road, Zhengzhou, Henan 450052, China.
Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, Hubei 430030, China.
Evid Based Complement Alternat Med. 2017;2017:6037037. doi: 10.1155/2017/6037037. Epub 2017 Mar 8.
The modified Simiao decoctions (MSD) have been wildly applied in the treatment of gouty arthritis in China. However, the evidence needs to be evaluated by a systematic review and meta-analysis. After filtering, twenty-four randomised, controlled trials (RCTs) comparing the effects of MSD and anti-inflammation medications and/or urate-lowering therapies in patients with gouty arthritis were included. In comparison with anti-inflammation medications, urate-lowering therapies, or coadministration of anti-inflammation medications and urate-lowering therapies, MSD monotherapy significantly lowered serum uric acid ( < 0.00001, mean difference = -90.62, and 95% CI [-128.38, -52.86]; < 0.00001, mean difference = -91.43, and 95% CI [-122.38, -60.49]; = 0.02, mean difference = -40.30, and 95% CI [-74.24, -6.36], resp.). Compared with anti-inflammation medications and/or urate-lowering therapies, MSD monotherapy significantly decreased ESR ( < 0.00001; mean difference = -8.11; 95% CI [-12.53, -3.69]) and CRP ( = 0.03; mean difference = -3.21; 95% CI [-6.07, -0.36]). Additionally, the adverse effects (AEs) of MSD were fewer ( < 0.00001; OR = 0.08; 95% CI [0.05, 0.16]). MSD are effective in the treatment of gouty arthritis through anti-inflammation and lowering urate. However, the efficacy of MSD should be estimated with more RCTs.
加味四妙汤在中国已广泛应用于痛风性关节炎的治疗。然而，其证据需要通过系统评价和荟萃分析来评估。经过筛选，纳入了24项比较加味四妙汤与抗炎药物和/或降尿酸治疗对痛风性关节炎患者疗效的随机对照试验（RCT）。与抗炎药物、降尿酸治疗或抗炎药物与降尿酸治疗联合使用相比，加味四妙汤单一疗法显著降低了血清尿酸（P<0.00001，平均差值=-90.62，95%置信区间[-128.38，-52.86]；P<0.00001，平均差值=-91.43，95%置信区间[-122.38，-60.49]；P=0.02，平均差值=-40.30，95%置信区间[-74.24，-6.36]）。与抗炎药物和/或降尿酸治疗相比，加味四妙汤单一疗法显著降低了红细胞沉降率（ESR）（P<0.00001；平均差值=-8.11；95%置信区间[-12.53，-3.69]）和C反应蛋白（CRP）（P=0.03；平均差值=-3.21；95%置信区间[-6.07，-0.36]）。此外，加味四妙汤的不良反应较少（P<0.00001；比值比=0.08；95%置信区间[0.05，0.16]）。加味四妙汤通过抗炎和降尿酸对痛风性关节炎有效。然而，加味四妙汤的疗效应以更多的随机对照试验来评估。
