天津中医药大学学报2023，Vol.42Issue(6)：714-724,11.DOI:10.11656/j.issn.1673-9043.2023.06.08
中西医结合治疗原发免疫性血小板减少症的系统评价及Meta分析
Systematic review and meta-analysis of integrated traditional Chinese medicine and western medicine for primary immune thrombocytopenia
摘要
Abstract
[Objective]To systematic review the clinical efficacy and safety of integrated traditional Chinese medicine(TCM)and western medicine in the treatment of primary immune thrombocytopenia(ITP).[Methods]Chinese and English databases such as CNKI,Wanfang,Pubmed and Embase were searched to screen the randomized controlled trial(RCT)of integrated TCM and western medicine for ITP.According to the Cochrane system evaluation method,the quality of the included literature was evaluated,the basic data were extracted,and the Rev Man 5.3 software was used for meta-analysis.[Results]After strict evaluation and screening,20 articles were finally included,including 1 538 subjects(782 in the observation group and 756 in the control group).Meta analysis results showed that the combination of traditional Chinese and western medicine treatment of ITP improved clinical efficacy[OR=3.42,95%CI(2.55,4.58),P＜0.000 01],peripheral platelet count[WMD=22.88,95%CI(17.48,28.28),P＜0.000 01],TCM syndrome efficacy[OR=5.32,95%CI(2.19,12.89),P=0.0002],Treg cell level[WMD= 0.59,95%CI(0.06,1.12),P= 0.03],CD4+T cell level[WMD=4.39,95%CI(2.72,6.06),P＜0.000 01],long-term efficacy[OR=3.37,95%CI(1.74,6.50),P=0.000 3],the reduction of TCM syndrome score[WMD=-5.69,95%CI(-7.30,-4.07),P＜0.000 01],CD8+T cell level[WMD=-3.30,95%CI(-5.07,-1.52),P=0.0003],platelet associated antibody IgG(PAIgG)level[WMD=-8.96,95%CI(-13.77,-4.15),P=0.000 3],and adverse reaction rate[OR=0.42,95%CI(0.20,0.89),P=0.02]were superior to those of western medicine alone,with statistically significant differences(P＜0.05).[Conclusion]The clinical efficacy and safety of integrated TCM and western medicine in the treatment of ITP are better than those of western medicine alone.However,due to the limitations of the study,more high-standard and high-quality randomized controlled trials are needed to further confirm.关键词
原发免疫性血小板减少症/中西医结合治疗/系统评价/Meta分析Key words
primary immune thrombocytopenia/integrated traditional Chinese and western medicine treatment/systematic review/meta-analysis分类
医药卫生引用本文复制引用
李润杰,李萌,倪润丰,范栗玮,王爱迪,刘宝山..中西医结合治疗原发免疫性血小板减少症的系统评价及Meta分析[J].天津中医药大学学报,2023,42(6):714-724,11.基金项目
国家自然科学基金项目(82004334) （82004334）
天津市中医重点专科建设项目 （）
天津市名中医传承工作室建设项目. （）
