Department of orthopedics, Tongling Traditional Chinese Medicine Hospital, Taipinghu Road, Tongling 244000, China.
Department of Orthopedics, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
J Tradit Chin Med. 2019 Jun;39(3):297-306.
To evaluate the clinical efficacy and safety of external application of Traditional Chinese Medicine (EATCM) on acute gouty arthritis (AGA).
Six electronic data bases were retrieved from their inception to march 2017. 15 randomized controlled clinical trials (RCTs) were included. The quality of the literatures was assessed according to Cochrane review criteria by using RevMan5.3 software; and related data was counted using Stata14.0 software.
There was no significant difference in C-reactiveprotein (CRP) between experimental intervention group and control group [(WMD = 1.093, 95% CI (-2.514, 4.701); P = 0.553)]. In terms of overall efficacy, the EATCM's treatment group was significantly superior to control group [(OR = 3.692; 95% CI (2.408, 5.661); P < 0.001)]. The EATCM was better than western medicine treatments or other interventions in reducing the adverse reactions [(OR = 0.135; 95% CI (0.067, 0.274); P < 0.001)]. All these funnel plots showed unlikelihood of publishing bias. But due to excessive heterogeneity, the statistical results of serum uric acid and visual analogue scale and CRP between the two groups became uncertain.
The results indicate that EATCM may have greater overall efficacy with fewer adverse drug reactions, although the evidence is weak owing to the low methodological quality and the small number of the included trials.
评估中药外敷治疗急性痛风性关节炎(AGA)的临床疗效和安全性。
检索建库至 2017 年 3 月的 6 个电子数据库,纳入 15 项随机对照临床试验(RCT)。采用 Cochrane 偏倚风险评估工具评价文献质量,采用 RevMan5.3 软件进行数据合并,采用 Stata14.0 软件进行数据分析。
实验组和对照组的 C 反应蛋白比较,差异无统计学意义[加权均数差(WMD)=1.093,95%可信区间(CI)(-2.514,4.701);P=0.553]。整体疗效方面,中药外敷组明显优于对照组[比值比(OR)=3.692,95%CI(2.408,5.661);P<0.001]。中药外敷组在降低不良反应发生率方面优于西药或其他干预措施[OR=0.135,95%CI(0.067,0.274);P<0.001]。所有漏斗图提示无发表偏倚,但由于各研究间异质性较大,组间血清尿酸、视觉模拟评分法和 C 反应蛋白的统计学结果变得不确定。
现有证据表明,中药外敷治疗 AGA 可能具有更好的整体疗效,且不良反应较少,但由于纳入研究方法学质量较低,样本量小,证据强度弱。