西部中医药2025，Vol.38Issue(3)：42-47,6.DOI:10.12174/j.issn.2096-9600.2025.03.09
中医内治法联合甲氨蝶呤治疗寒湿痹阻型类风湿关节炎有效性与安全性的Meta分析
The Effectiveness and Safety of TCM Internal Therapy and Methotrexate in the Treatment of Rheumatoid Arthritis of Cold-dampness Obstruction Pattern:A Meta Analysis
摘要
Abstract
Objective:To evaluate clinical effects and the safety of TCM internal therapy and methotrexate(MTX)in the treatment of rheumatoid arthritis(RA)of cold-dampness obstruction pattern.Methods:Randomized controlled trials(RCTs)on the treatment of cold-dampness obstruction type of RA with TCM internal therapy and MTX were searched from CNKI,VIP,Wanfang,CBMdisc,Web of Science,PubMed,EMbase database and Cochrane library,and the retrieval time was between the time of establishing the database and November 2023.According to the inclusion and exclusion criterion,two researchers carried out the literature screening,data extraction,quality evaluation independently,and intersected the check results,and performed Meta analysis using RevMan 5.3 software.Results:The study included 15 RCTs,involving 1 356 patients.Meta analysis results displayed that the study group was better than the control group in the increase in effective rate(RR=1.20,95%CI:1.14-1.27,P<0.000 01),morning stiffness time(SMD=0.75,95%CI:0.59-0.90,P<0.000 01),number of swollen joints(MD=0.59,95%CI:0.50-0.68,P<0.000 01),the number of tender joints(MD=0.71,95%CI:0.58-0.84,P<0.000 01),ESR(MD=6.16,95%CI:5.02-7.31,P<0.000 01),CRP(MD=1.48,95%CI:0.71-2.25,P=0.000 2),as well as adverse reaction(RR=0.45,95%CI:0.31-0.65,P<0.000 01),and the difference showed statistical meaning;while the difference had no statistical meaning in the influence on TNF-α(MD=-0.17,95%CI:-1.41-1.08,P=0.79).13 of these RCTs focused on adverse reactions and seven studies reported the incidences of adverse reactions in detail,and no serious adverse reactions have been reported in any of the literature.Conclusion:Currently,clinical evidence primarily reveals that the effectiveness and the safety of TCM internal therapy and MTX in the treatment of RA might be better than these of single use of MTX,however,we still need high quality RCTs to perform the validation.关键词
类风湿关节炎/寒湿痹阻/系统评价/中西药联用/甲氨蝶呤/Meta分析Key words
rheumatoid arthritis/cold-dampness obstruction/systematic assessment/traditional Chinese medicine combined with Western medicine/methotrexate/Meta analysis分类
医药卫生引用本文复制引用
毕映燕,程晓华,李翔,李喜香..中医内治法联合甲氨蝶呤治疗寒湿痹阻型类风湿关节炎有效性与安全性的Meta分析[J].西部中医药,2025,38(3):42-47,6.基金项目
2015年度中医药行业科研专项(201507001-06) （201507001-06）
甘肃省中医药科研项目(GZK-2019-1) （GZK-2019-1）
2022年中央转移支付医疗服务与保障能力提升中医药事业传承与发展部分——中医药人才培养重点学科建设项目(甘财社[2022]48号). （甘财社[2022]48号）
