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独活寄生汤联合西药治疗强直性脊柱炎的疗效及安全性的系统评价和 Meta 分析。

Efficacy and safety of Duhuo Jisheng decoction combined with Western medicine in the treatment of ankylosing spondylitis: A systematic review and meta-analysis.

机构信息

First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China; National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300381, China; Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China.

Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China.

出版信息

Complement Ther Clin Pract. 2023 May;51:101739. doi: 10.1016/j.ctcp.2023.101739. Epub 2023 Feb 18.

Abstract

BACKGROUND

and purpose: The effects of Duhuo Jisheng Decoction (DJD) on ankylosing spondylitis (AS) remain controversial. This study aimed to assess the efficacy and safety of DJD combined with Western medicine in treating AS.

METHODS

A total of nine databases were searched from the establishment of the databases to August 13th, 2021, for randomized controlled trials (RCTs) concerning the use of DJD combined with Western medicine to treat AS. Review Manager was used for the meta-analysis of the retrieved data. The risk of bias was evaluated using the revised Cochrane risk of bias tool for RCTs.

RESULTS

The results indicated that the combinational use of DJD and Western medicine resulted in significantly higher outcomes in terms of effective rate (RR = 1.40, 95% CI: 1.30, 1.51); thoracic mobility (MD = 0.32, 95% CI: 0.21, 0.43); morning stiffness time (SMD = -0.38, 95% CI: 0.61, -0.14); BASDAI (MD = -0.84, 95% CI: 1.57, -0.10); VAS for pain [spinal (MD = -2.76, 95% CI: 3.10, -2.42); peripheral joint (MD = -0.84, 95% CI: 1.16, -0.53)]; CRP (MD = -3.75, 95% CI: 6.36, -1.14); ESR: (MD = -4.80, 95% CI: 7.63, -1.97); and adverse reactions (RR = 0.50, 95% CI: 0.38, 0.66) in comparison to the Western medicine alone in treating AS.

CONCLUSION

Compared to the use of Western medicine, DJD combined with Western medicine improves the effective rate, functional scores, and symptoms of AS patients, with a reduced rate of adverse reactions.

摘要

背景和目的

独活寄生汤(DJD)治疗强直性脊柱炎(AS)的疗效仍存在争议。本研究旨在评估 DJD 联合西药治疗 AS 的疗效和安全性。

方法

从各数据库建立至 2021 年 8 月 13 日,检索 DJD 联合西药治疗 AS 的随机对照试验(RCT),采用 Review Manager 对检索数据进行荟萃分析。采用 Cochrane 偏倚风险评估工具评估 RCT 的风险。

结果

结果表明,DJD 联合西药治疗在有效率(RR=1.40,95%CI:1.30,1.51)、胸腰椎活动度(MD=0.32,95%CI:0.21,0.43)、晨僵时间(SMD=-0.38,95%CI:0.61,-0.14)、BASDAI(MD=-0.84,95%CI:1.57,-0.10)、疼痛视觉模拟评分(VAS)[脊柱(MD=-2.76,95%CI:3.10,-2.42);外周关节(MD=-0.84,95%CI:1.16,-0.53)]、C 反应蛋白(MD=-3.75,95%CI:6.36,-1.14)、红细胞沉降率(ESR:MD=-4.80,95%CI:7.63,-1.97)和不良反应发生率(RR=0.50,95%CI:0.38,0.66)方面均优于西药治疗。

结论

与单纯使用西药相比,DJD 联合西药可提高 AS 患者的有效率、功能评分和症状缓解率,且不良反应发生率降低。

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