补中益气汤联合常规西药治疗重症肌无力疗效和安全性Meta分析
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R746.1

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北京中医药大学新奥优秀传承团队项目(1000062720028/010);北京市中医管理局王永炎名医传承工作站项目;北京 中医药大学东方医院人才培养计划项目


Meta-analysis on Curative Effect and Safety of Buzhong Yiqi Tang Combined with Routine Western Medicine for Myasthenia Gravis
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    摘要:

    目的:对补中益气汤治疗重症肌无力的临床疗效及安全性进行系统评价。方法:计算机检索2007年1月—2017年9月中国知网(CNKI)、万方数据知识服务平台、维普中文期刊数据库(VIP)、中国生物医学文献数据库(CBM)、PubMed、Cochrane Library、科学引文索引(SCI)数据库,选取临床随机对照试验,对符合入选标准者采用Cochrane推荐的偏倚风险评估方法评价偏倚风险,提取资料,应用ReviewManager5.3进行Meta分析。结果:最终纳入13项临床研究,总病例数795例;分析结果显示补中益气汤联合常规西药治疗重症肌无力与单纯应用常规西药比较,治疗组有效率优于对照组,差异有统计学意义[OR=3.36,95%CI(2.35,4.81),P<0.000 01];复发率方面治疗组低于对照组,差异有统计学意义[OR=0.11,95%CI(0.04,0.34),P<0.000 1];治疗组的不良反应发生率也低于对照组,差异有统计学意义[OR=0.24,95%CI(0.10,0.54),P=0.000 6]。结论:补中益气汤联合常规西药治疗重症肌无力能显著改善患者的临床症状、提高用药安全性;由于纳入研究文献质量偏低,有待高质量、大样本、随机对照双盲临床试验提供证据,以进一步验证补中益气汤联合常规西药治疗重症肌无力的临床疗效和安全性。

    Abstract:

    Objective:To systematically evaluate the clinical effect and safety of Buzhong Yiqi tang for myasthenia gravis.Methods:Searched for literature from January 2007 to September 2017 in Chinese National Knowledge Infrastructure(CNKI),Wanfang Data Knowledge Service Platform,VIP Chinese Journal Database(VIP),Chinese Biological Medical Disc(CBM),PubMed,Cochrane Library and Science Citation Index(SCI)Database.Selected clinical randomized controlled trials,adapted the assessment method of risk of bias recommended by Cochrane to evaluate risk of bias of patients who met the inclusion criteria and extracted the data.The meta-analysis was conducted via Review Manager 5.3 software.Results:Thirteen clinical studies were included,including 795 cases totally.The result showed that when compared the therapy of Buzhong Yiqi tang combined with routine western medicine for myasthenia gravis with that of simple routine western medicine,the effective rate in the treatment group was superior to that in the control group,the difference being significant[OR=3.36,95%CI(2.35,4.81),P < 0.000 01];the recurrence rate in the treatment group was lower than that in the control group,the difference being significant[OR=0.11,95%CI(0.04,0.34),P < 0.000 1];the incidence of adverse reactions in the treatment group was lower than that in the control group,the difference being significant[OR=0.24,95%CI(0.10,0.54),P=0.000 6].Conclusion:The therapy of Buzhong Yiqi tang combined with routine western medicine for myasthenia gravis can effectively improve clinical symptoms of patients and improve safety of medication.However,due to the low quality of selected literature,the clinical effect and safety of Buzhong Yiqi tang for myasthenia gravis need to be verified through the literature of higher quality and larger sample as well as randomized controlled doubled-blinded clinical trials.

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赵钟辉,王建伟,高维,张胜利,郭蓉娟.补中益气汤联合常规西药治疗重症肌无力疗效和安全性Meta分析[J].新中医,2018,50(6):42-46

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  • 在线发布日期: 2018-06-05
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