中国医院用药评价与分析2024，Vol.24Issue(9)：1102-1108,7.DOI:10.14009/j.issn.1672-2124.2024.09.018
活血化瘀法对寻常型银屑病炎症细胞因子和疗效影响的Meta分析及用药规律研究
Meta-Analysis on Effects of Activating Blood Circulation and Removing Blood Stasis on Inflammatory Cytokines and Efficacy in Psoriasis Vulgaris and Medication Rules
摘要
Abstract
OBJECTIVE:To systematically review the effects of activating blood circulation and removing blood stasis on inflammatory cytokines and efficacy in psoriasis vulgaris and medication rules.METHODS:CNKI,VIP,Wanfang Data,CBM,PubMed,the Cochrane Library and Embase databases were retrieved to collect randomized controlled trials(RCT)of method of activating blood circulation and removing blood stasis in the treatment of psoriasis vulgaris.The retrieval time was from the establishment of the data base to Sept.2023.Literature screening and data extraction were independently conducted by two researchers.The quality of included studies was evaluated by the modified Jadad scale.Meta-analysis was performed by Stata 17.0.After the extracted names of traditional Chinese medicine were normalized,the frequency of high-frequency drug use were counted by Microsoft Excel 2019,the drug association rules were analyzed by SPSS modeler 18.0,and the complex network diagram of traditional Chinese medicine was drawn by Cytoscape 3.10.1.RESULTS:A total of 15 studies were included,with a total sample size of 1 541 cases(10 cases dropped,1 531 cases actually included),including 770 cases in the observation group(6 cases dropped,764 cases actually included,received formula of activating blood circulation and removing blood stasis as the main effectand or combined with other therapy),771 cases in the control group(4 cases dropped,767 cases actually included,received formula do not primarily focus on activating blood circulation and removing blood stasis or utilize Western medical treatments).Meta-analysis showed that the expression level of inflammatory cytokines in the observation group was better than that in the control group,with statistically significant difference(SMD=-1.243,95%CI=-1.785--0.701,P=0.000).Subgroup analysis of inflammatory cytokines showed that compared with the control group,the expression levels of interleukin(IL)2,IL-4,IL-10,IL-17,IL-23,tumor necrosis factor α and gamma interferon in observation group were significantly improved,with statistically significant difference(P<0.05),there was no significant difference in IL-18 level between two groups(P=0.708).The total effective rate of observation group was higher than that of control group(RR=1.211,95%CI=1.157-1.268,P=0.000),and PASI score was lower than that of control group(WMD=-2.756,95%CI=-3.359--2.153,P=0.000),the differences were statistically significant.There was no significant difference in the incidence of adverse drug reactions between two groups(RR=0.838,95%CI=0.581-1.208,P=0.344).Date mining showed that a total of 15 prescriptions were enrolled,including 57 traditional Chinese medicines.The total frequency of drugs was 181 times,and frequency of 7 traditional Chinese medicines were≥9 times.Results of association rule analysis showed that high-frequency drugs and core drugs used in the treatment of psoriasis vulgaris by activating blood circulation and removing blood stasis included Carthami flos,Angelicae sinensis radix,Juglandis semen,Radix salviae,Spatholobus suberectus dunn,Rehmannia glutinosa,Smilacis Glabrae Rhixoma,and licorice.And the commonly used drug pairs included Juglandis semen-Carthami flos,Juglandis semen-Angelicae sinensis radix,Carthami flos-Angelicae sinensis radix.CONCLUSIONS:The method of activating blood circulation and removing blood stasis can improve the level of inflammatory cytokines in psoriasis vulgaris,regulate the inflammatory response,relieve the symptoms of psoriasis lesions,and improve the clinical efficacy.The high-frequency drugs and core drugs used are Carthami flos,Angelicae sinensis radix,Juglandis semen,Radix salviae,Spatholobus suberectus dunn,Rehmannia glutinosa,Smilacis Glabrae Rhixoma,and licorice.However,high-quality,large sample,multi-center randomized double-blind clinical trials are still needed to verify the above research results in the future.关键词
寻常型银屑病/活血化瘀法/炎症细胞因子/Meta分析/用药规律/数据挖掘Key words
Psoriasis vulgaris/Method of activating blood circulation and removing blood stasis/Inflammatory cytokines/Meta-analysis/Medication rules/Data mining分类
医药卫生引用本文复制引用
朱正金,闫小宁,李美红,陈璐,贾晨阳,李文彬..活血化瘀法对寻常型银屑病炎症细胞因子和疗效影响的Meta分析及用药规律研究[J].中国医院用药评价与分析,2024,24(9):1102-1108,7.基金项目
国家自然科学基金资助项目(No.82174386) （No.82174386）
第二批省级中医药青年科技骨干人才项目(No.2023-ZQNY-011) （No.2023-ZQNY-011）
陕西省重点研发计划一般项目(No.2021SF-409) （No.2021SF-409）
