Department of Hematology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Xiuying District, Haikou City, Hainan Province, China.
Medicine (Baltimore). 2021 Apr 2;100(13):e25341. doi: 10.1097/MD.0000000000025341.
Idiopathic thrombocytopenic purpura (ITP) is a common immune system and blood system disease in clinical practice, and it is a hemorrhagic disease caused by immune factors causing platelet destruction and decreasing number of platelets. There is currently no effective treatment plan for ITP. At this stage, glucocorticoid and gamma globulin are mostly used in the treatment of ITP, and some patients use splenectomy to achieve therapeutic purposes, but the various treatment methods are inadequate. At this stage, a large number of randomized controlled studies have reported that Chinese herbal medicine has achieved good curative effect in the treatment of ITP. However, due to the variety of Chinese herbal medicine, there has been no evidence of the effectiveness and safety of Chinese herbal medicine in the treatment of ITP. Because of the above reasons, this study uses the network meta-analysis method based on Bayesian method to compare the clinical efficacy and safety of different kinds of Chinese herbal medicine in the treatment of ITP through direct and indirect comparison, in order to provide evidence-based medical support for the treatment of ITP with Chinese herbal medicine.
This study uses the method of combining free words with theme words, and using computer to retrieve PubMed, EMbase, The Cochrane Library, WANFANG Database, CNKI, and VIP Database, etc, to collect the randomized control studies on Chinese herbal medicine in the treatment of ITP. The retrieval time is from the establishment of each database to January 2021, and the retrieval languages are Chinese and English. Two researchers independently read the title, abstract and full text of the article to determine whether it is included in the literature; In the event of a disagreement, a third researcher will join the discussion to resolve the disagreement; For the literature that lacks information, trying to contact the original author of the document to supplement it. The literature quality evaluation carried out by using the Stata 14.0 software to draw network and funnel plots, in accordance with the quality evaluation criteria of version 5.1.0 of the Cochrane System Evaluation Manual. Statistical analysis is performed by using ADDIS 1.16.8 software based on the Bayesian model.
This study will compare the clinical efficacy and safety of different types of Chinese herbal medicine in the treatment of idiopathic thrombocytopenic purpura through the method of network meta-analysis, and rank the different types of Chinese herbal medicine according to their effectiveness, and the results will be published in a peer-reviewed, high-quality academic journal.
This study will find effective and safe Chinese herbal medicine for clinical treatment of ITP from the perspective of evidence-based medicine, and benefit more ITP patients.
特发性血小板减少性紫癜（ITP）是临床实践中常见的免疫系统和血液系统疾病，是一种由免疫因素引起的血小板破坏和血小板数量减少导致的出血性疾病。目前针对 ITP 尚无有效的治疗方案，现阶段治疗 ITP 多采用糖皮质激素和丙种球蛋白，部分患者采用脾切除术来达到治疗目的，但各种治疗方法都不够完善。现阶段大量的随机对照研究报道，中草药在治疗 ITP 中取得了较好的疗效，但由于中草药种类繁多，尚缺乏中草药治疗 ITP 的有效性和安全性证据。基于上述原因，本研究采用基于贝叶斯法的网络荟萃分析方法，通过直接和间接比较，比较不同种类的中草药治疗 ITP 的临床疗效和安全性，为中草药治疗 ITP 提供循证医学支持。
本研究采用自由词与主题词相结合的方法，计算机检索 PubMed、EMbase、The Cochrane Library、万方数据库、中国知网、维普数据库等，收集中草药治疗 ITP 的随机对照研究。检索时间从各数据库建立至 2021 年 1 月，检索语言为中文和英文。两名研究者独立阅读文章的标题、摘要和全文，以确定文献是否纳入；若意见不一致，则由第三位研究者加入讨论以解决分歧；对于信息缺失的文献，尝试与文献的原始作者联系以补充信息。采用 Stata 14.0 软件进行文献质量评价，并绘制网络和漏斗图，按照 Cochrane 系统评价手册 5.1.0 版的质量评价标准进行。基于贝叶斯模型，采用 ADDIS 1.16.8 软件进行统计分析。
本研究将通过网络荟萃分析的方法比较不同种类的中草药治疗特发性血小板减少性紫癜的临床疗效和安全性，并根据疗效对不同种类的中草药进行排名，研究结果将发表在同行评议的高质量学术期刊上。
本研究将从循证医学的角度寻找治疗 ITP 的有效、安全的中草药，使更多的 ITP 患者受益。
