Department of Rheumatology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
Front Immunol. 2023 Mar 8;14:1114930. doi: 10.3389/fimmu.2023.1114930. eCollection 2023.
Traditional Chinese medicines (TCMs), such as Tripterygium wilfordii Hook F (TwHF), Glycyrrhiza uralensis, Caulis sinomenii and others have anti-inflammatory effects. They are widely used in China to treat rheumatoid arthritis (RA), but proof of their use as an evidence-based medicine is little. The aim of this network meta-analysis (NMA) was to evaluate the efficacy and safety of TCMs.
By searching online databases and using a manual retrieval method, randomized controlled trials (RCTs) that met specific selection criteria were included in the meta-analysis. The search included papers that were published between the establishment of the databases and November 10, 2022. Analyses were performed using Stata software (version 14) and Review Manager (version 5.3).
61 papers with 6316 subjects were included in the current NMA. For ACR20, MTX plus SIN therapy (94.30%) may be a significant choice. For ACR50 and ACR70, MTX plus IGU therapy (95.10%, 75.90% respectively) performed better than other therapies. IGU plus SIN therapy (94.80%) may be the most promising way to reduce DAS-28, followed by MTX plus IGU therapy (92.80%) and TwHF plus IGU therapy (83.80%). In the analysis of the incidence of adverse events, MTX plus XF therapy (92.50%) had the least potential, while LEF therapy (22.10%) may cause more adverse events. At the same time, TwHF therapy, KX therapy, XF therapy and ZQFTN therapy were not inferior to MTX therapy.
TCMs with anti-inflammatory effect were not inferior to MTX therapy in the treatment of RA patients. Combining with TCMs can improve the clinic efficacy and reduce the possibility of adverse events of DMARDs, which may be a promising regimen.
https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022313569.
雷公藤（TwHF）、甘草、青风藤等中药具有抗炎作用。它们在中国被广泛用于治疗类风湿关节炎（RA），但作为循证医学的证据很少。本网络荟萃分析（NMA）旨在评估中药的疗效和安全性。
通过在线数据库搜索和手动检索方法，纳入符合特定选择标准的随机对照试验（RCT）进行荟萃分析。检索包括自数据库建立至 2022 年 11 月 10 日发表的论文。使用 Stata 软件（版本 14）和 Review Manager（版本 5.3）进行分析。
纳入了 61 篇文献，共 6316 例受试者。对于 ACR20，MTX 联合 SIN 治疗（94.30%）可能是一个显著的选择。对于 ACR50 和 ACR70，MTX 联合 IGU 治疗（95.10%，75.90%）优于其他治疗方法。IGU 联合 SIN 治疗（94.80%）可能是降低 DAS-28 的最有前途的方法，其次是 MTX 联合 IGU 治疗（92.80%）和 TwHF 联合 IGU 治疗（83.80%）。在不良事件发生率分析中，MTX 联合 XF 治疗（92.50%）潜在风险最小，而 LEF 治疗（22.10%）可能会引起更多的不良事件。同时，TwHF 治疗、KX 治疗、XF 治疗和 ZQFTN 治疗并不逊于 MTX 治疗。
具有抗炎作用的中药在治疗 RA 患者方面并不逊于 MTX 治疗。与 TCM 联合使用可以提高临床疗效，降低 DMARDs 不良事件的可能性，这可能是一种有前途的方案。
https://www.crd.york.ac.uk/PROSPERO/，标识符 CRD42022313569。
