Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital University of Medicine Sciences, Beijing 100010, China.
Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing100700, China.
J Tradit Chin Med. 2020 Aug;40(4):509-517. doi: 10.19852/j.cnki.jtcm.2020.04.001.
To evaluate the effectiveness of Chinese herbal medicine for primary Raynaud's phenomenon (PRP).
The Cochrane Central Register of Controlled Trials, PubMed, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, China Science and Technology Journal Database, and Wanfang Database were searched up to February 13, 2018. Randomized controlled trials (RCTs) on treatment of PRP with Chinese herbal medicine compared with placebo, blank control, lifestyle changes, or calcium antagonists were identified and reviewed. The quality of included trials was assessed using a risk of bias tool.
Eight RCTs involving 674 participants were included. The methodological quality of the included trials was generally poor. Meta-analysis of two trials showed that Buyang Huanwu Tang plus Danggui Sini Tang produced greater improvement in global symptoms than nifedipine. One trial showed that Danggui Sini Tang and a self-composed Chinese herbal medicine decoction, respectively, produced greater improvement in global symptoms than nifedipine alone. In one trial, modified Danggui Sini Tang showed greater improvement in global symptoms and arterial peak systolic velocity compared with nifedipine. One trial showed that Jiejing Tongmi Tang produced greater improvement in global symptoms, plasma endothelin, and plasma nitric oxide than cinepazide maleate injection. However, Jiejing Tongmi Tang did not produce a significant difference in skin temperature and peripheral artery blood stream drawing after cold pressor testing compared with cinepazide maleate injection. None of the trials reported frequency of attacks, duration of attacks, participant preference scores, or adverse events.
Chinese herbal medicine may have a positive effective on PRP. However, owing to weak methodology, the benefits of Chinese herbal medicine for PRP are inconclusive. More rigorously designed studies are needed to confirm these findings.
评价中药治疗原发性雷诺现象（PRP）的疗效。
检索 Cochrane 对照试验中心注册库、PubMed、中国生物医学文献数据库、中国知网、中国科技期刊数据库和万方数据库，搜集中药治疗 PRP 的随机对照试验，与安慰剂、空白对照、生活方式改变或钙通道阻滞剂比较。采用偏倚风险评估工具评价纳入研究的质量。
纳入 8 项 RCT，共 674 例患者。纳入研究的方法学质量普遍较差。2 项试验的 Meta 分析结果显示，补阳还五汤联合当归四逆汤的整体症状改善优于硝苯地平。1 项试验显示，当归四逆汤和自拟中药汤剂分别优于硝苯地平单药治疗。1 项试验中，加味当归四逆汤在整体症状和动脉收缩期峰值速度方面的改善优于硝苯地平。1 项试验显示，接经通脉汤在整体症状、血浆内皮素和血浆一氧化氮方面的改善优于桂哌齐特。然而，与桂哌齐特相比，接经通脉汤在冷加压试验后皮肤温度和外周动脉血流描记方面无显著差异。所有试验均未报告发作频率、发作持续时间、患者偏好评分或不良反应。
中药可能对 PRP 有积极作用。但是，由于方法学薄弱，中药治疗 PRP 的疗效尚不确定。需要更多设计严谨的研究来证实这些发现。
