| 引用本文:陈茉，文颖娟，彭高强，王河江，仝武宁.中西医结合疗法对重症肌无力的Meta分析及用药规律[J].世界中医药,2022,(17):. |
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| 中西医结合疗法对重症肌无力的Meta分析及用药规律 |
| Meta-analysis and Medication Regularity of Integrated Traditional Chinese and Western Medicine on Myasthenia Gravis |
| 投稿时间：2020-11-26 |
| DOI：10.3969/j.issn.1673-7202.2022.17.012 |
| 中文关键词: 中西医结合 重症肌无力 Meta分析 安全性评价 中医证候 脾胃经 补气药 用药规律 |
| English Keywords:Integrated traditional Chinese and western medicine MG Meta-analysis Safety evaluation TCM syndrome Spleen and stomach meridians Qi-tonifying drug Medication regularity |
| 基金项目:国家重点研发计划项目（2017YFC1703506）——中医药大数据挖掘研究与创新应用；国家自然科学基金项目（81202642）——基于“脾主肌肉”的葛根及其配伍对重症肌无力大鼠骨骼肌线粒体调控机制研究；第四批全国中医（临床、基础）优秀人才研修项目{国中医药人教发[2017]24号}；陕西省科学技术厅资助项目（2017SF-323）——基于“脾主肌肉”的葛根及其配伍对糖尿病心肌病大鼠心肌作用机制研究 |
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| 中文摘要: |
| 目的：系统评价中西医结合治疗重症肌无力（MG）的安全性并挖掘选方用药规律。方法：计算机检索国家知识基础设施数据库（CNKI）、中国学术期刊数据库（CSPD）、中文科技期刊数据库（CCD）、PubMed、Cochrane Library等国内外数据库中有关应用中西医结合治疗MG的临床随机对照试验。结合文献纳入与排除标准，分别由2名研究员独立筛选文献并进行文献质量评价。使用Revman5.4软件进行操作。结果：共纳入12项研究，涉及病例1 048例。Meta分析结果显示，应用中西医结合治疗MG患者的临床绝对评分（MD=2.75，95%CI为1.49~4.02，P<0.000 1）、中医证候评分（MD=2.21，95%CI为1.15~3.27，P<0.000 1），临床总有效率、安全性评价均高于对照组（均P<0.05）。对12项研究选方进行讨论，剔除重复方剂1首，共纳入11首方剂。涉及45味中药，总频次108次；以补气药、补阳药、补阴药为主；多为归肝经、脾经、胃经的药物。高频药物包括黄芪、陈皮、当归、白术等。结论：与对照组比较，运用中西医结合治疗MG安全有效，且不良反应发生较少。但由于所纳入试验文献的总体研究质量较为一般，其疗效与安全性评价仍需设计更为严谨的高质量随机对照试验进行佐证。 |
| English Summary: |
| To systematically evaluate the safety of integrated traditional Chinese and western medicine in the treatment of myasthenia gravis(MG) and explore the prescription selection and medication regularity.Methods:Databases，such as CNKI，Wanfang Data，VIP，PubMed，and Cochrane Library were searched for clinical randomized controlled trials(RCTs) on the application of integrated traditional Chinese and western medicine in the treatment of MG.Two researchers independently screened the research articles and evaluated the quality using Revman 5.4 according to the inclusion and exclusion criteria.Results:Twelve RCTs were enrolled，involving 1 048 cases.The Meta-analysis results showed that the integrated traditional Chinese and western medicine group was superior to the control group in terms of clinical absolute score(MD=2.75，95%CI 1.49 to 4.02，P<0.000 1)，TCM syndrome score(MD=2.21，95%CI 1.15 to 3.27，P<0.000 1)，total clinical effective rate，and safety evaluation(all P<0.05).The selected prescriptions in 12 RCTs were discussed.One repeated prescription was excluded，and 11 prescriptions were included.Forty-five Chinese herbal drugs were involved with a total frequency of 108 times，which were dominated by qi-tonifying，yang-tonifying，and yin-tonifying drugs，and the majority of the drugs acted on the liver，spleen，and stomach meridians.High-frequency drugs included Astragali Radix，Citri Reticulatae Pericarpium，Angelicae Sinensis Radix，and Atractylodis Macrocephalae Rhizoma.Conclusion:Compared with the control group，the integrated traditional Chinese and western medicine is safe and effective in the treatment of MG，with few adverse reactions.However，due to the moderate quality of the included RCTs，the efficacy and safety still need to be further confirmed by more rigorously designed high-quality RCTs. |
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