Zhou Ying-Yan, Xia Xuan, Peng Wen-Ke, Wang Qin-He, Peng Jian-Hong, Li Yan-Lin, Wu Jian-Xiong, Zhang Jian-Yong, Zhao Yue, Chen Xiu-Min, Huang Run-Yue, Jakobsson Per-Johan, Wen Ze-Huai, Huang Qing-Chun
Key Unit of Methodology in Clinical Research, Department of Rheumatology, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.
Postdoctoral Mobile Research Station, Guangzhou University of Chinese Medicine, Guangzhou, China.
Front Pharmacol. 2018 Apr 16;9:356. doi: 10.3389/fphar.2018.00356. eCollection 2018.
To conduct a meta-analysis of the effectiveness and safety of (TwHF) extracts for the treatment of rheumatoid arthritis (RA). A systematic literature search was conducted in PubMed, EMBASE, Cochrane, Medline, CNKI, SinoMed and WanFang Library till 12 July 2017. All included studies were analyzed with the use of the Review Manager 5.2 software according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement protocol. Fourteen randomized controlled trials (RCTs) were identified. TwHF extracts provided a statistically significant improvement in grip strength (GS), swelling joint count (SJC) and morning stiffness (MS) compared with placebo ( < 0.001). The meta-analysis showed significant differences between TwHF extract-treated group and the DMARDs group in GS, MS, C-reactive protein (CRP), and tender joint count (TJC) ( < 0.05), aside from ESR and SJC ( > 0.05). The pooled results also displayed significant differences between the combination of TwHF extracts with DMARDs and the DMARDs alone group in ESR, CRP, SJC, and TJC ( ≤ 0.05). For the safety analysis, two trials favored TwHF extract-treatment and one trial favored non-TWHF extract-treatment in AEs ( < 0.05). Eleven trials showed no statistically significant differences between TwHF extract-treated group and the DMARDs group ( > 0.05). The findings of this systematic review with meta-analysis indicate that TwHF extracts provides statistically significant and clinically important improvement in RA symptoms and has an acceptable safety profile.
对雷公藤提取物治疗类风湿关节炎（RA）的有效性和安全性进行荟萃分析。截至2017年7月12日，在PubMed、EMBASE、Cochrane、Medline、中国知网、中国生物医学文献数据库和万方数据库中进行了系统的文献检索。所有纳入研究均根据系统评价和荟萃分析的首选报告项目（PRISMA）声明方案，使用Review Manager 5.2软件进行分析。共纳入14项随机对照试验（RCT）。与安慰剂相比，雷公藤提取物在握力（GS）、关节肿胀计数（SJC）和晨僵（MS）方面有统计学意义的改善（P<0.001）。荟萃分析显示，除红细胞沉降率（ESR）和关节肿胀计数（SJC）外（P>0.05），雷公藤提取物治疗组与改善病情抗风湿药（DMARDs）组在握力、晨僵、C反应蛋白（CRP）和压痛关节计数（TJC）方面存在显著差异（P<0.05）。汇总结果还显示，雷公藤提取物与DMARDs联合治疗组和单用DMARDs组在ESR、CRP、SJC和TJC方面存在显著差异（P≤0.05）。在安全性分析方面，两项试验显示雷公藤提取物治疗组在不良事件方面更具优势，一项试验显示非雷公藤提取物治疗组更具优势（P<0.05）。11项试验显示雷公藤提取物治疗组与DMARDs组之间无统计学意义的差异（P>0.05）。这项系统评价和荟萃分析的结果表明，雷公藤提取物在类风湿关节炎症状方面有统计学意义且具有临床重要性的改善，并且具有可接受的安全性。
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