| 引用本文:杜少鹏1，2，刘维1，2，樊一桦1，2，曾苹1，2，王爱华1，2.桂枝芍药知母汤联合西药治疗急性痛风性关节炎的疗效和安全性Meta分析[J].世界中医药,2023,(06):. |
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| 桂枝芍药知母汤联合西药治疗急性痛风性关节炎的疗效和安全性Meta分析 |
| Meta-analysis of Efficacy and Safety of Guizhi Shaoyao Zhimu Decoction Combined with Western Medicine in the Treatment of Acute Gouty Arthritis |
| 投稿时间：2021-07-26 |
| DOI：10.3969/j.issn.1673-7202.2023.06.011 |
| 中文关键词: 桂枝芍药知母汤 急性痛风性关节炎 高尿酸血症 秋水仙碱 中医药 非甾体抗炎药 系统评价 随机对照试验 |
| English Keywords:Guizhi Shaoyao Zhimu Decoction Acute gouty arthritis Hyperuricemia Colchicine Traditional Chinese medicine Non-steroidal anti-inflammatory drugs Systematic evaluation Randomized controlled trials |
| 基金项目:国家自然科学基金面上项目（81673927）；天津市科技计划项目（15ZXLCSY00020）；国家中医药管理局“十二五”中医药重点学科能力提升项目（2018ZDXK001） |
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| 中文摘要: |
| 目的：系统评价桂枝芍药知母汤联合西药治疗急性痛风性关节炎的安全性和疗效。方法：计算机检索PubMeb、The Cochrane Library、EMBASE、Web of Science、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）和中国生物医学文献数据库（CBM），搜索桂枝芍药知母汤联用西药与单用西药治疗急性痛风性关节炎的疗效与安全性临床随机对照试验，并用改良后的Jadad量表对纳入的文献质量进行初步评价，利用Revman5.3软件进行Meta分析。结果：共纳入7篇文献，共498例患者。Meta分析结果显示：中西药联用观察组患者总有效率明显高于西药对照组，差异有统计学意义（RR=1.20，95%CI为1.12～1.28，P<0.000 01）；中西药联用观察组在降低BUA（MD=-61.35，95%CI为-93.17～-29.53），CRP（MD=-1.83，95%CI为-2.56～-1.11），ESR（MD=-3.93，95%CI为-6.60～-1.26），关节肿胀积分（SMD=-2.89，95%CI为-3.36～-2.43）和关节疼痛积分（SMD=-3.11，95%CI为-3.87～-2.35）的效果明显优于西药对照组，差异有统计学意义（P<0.05）；中西药联用干预的观察组不良反应发生率明显低于西药对照组（P<0.05）。结论：桂枝芍药知母汤联合西药治疗急性痛风性关节炎的疗效和安全性明显优于单用西药，但受纳入研究质量和数量的限制，仍需更多高质量的临床随机对照试验来证实上述结论。 |
| English Summary: |
| To systematically evaluate the safety and efficacy of Guizhi Shaoyao Zhimu Decoction combined with western medicine in the treatment of acute gouty arthritis(AGA).Methods:PubMeb，the Cochrane Library，EMBASE，Web of Science，China National Knowledge Infrastructure(CNKI)，Wanfang database，VIP database，and China Biology Medicine disc(CBM) were searched by computer for randomized controlled clinical trials(RCTs) on the efficacy and safety of Guizhi Shaoyao Zhimu Decoction combined with western medicine or western medicine alone in the treatment of AGA.The quality of the included literature was preliminarily evaluated with the improved Jadad scale，and the data on the preliminary evaluation were Meta-analyzed with Revman 5.3 software.Results:A total of 498 patients were included in 7 papers.Meta-analysis showed that the total effective rate of the observation group(Chinese medicine combined with western medicine) was significantly higher than that in the control group(western medicine alone)(RR=1.20，95%CI 1.12 to 1.28，P<0.000 01).The effects of the observation group on reducing blood uric acid(BUA，MD=-61.35，95%CI -93.17 to -29.53)，C-reactive protein(CRP，MD=-1.83,95%CI -2.56 to -1.11)，erythrocyte sedimentation rate(ESR，MD=-3.93，95%CI -6.60 to -1.26)，joint swelling score(SMD=-2.89，95%CI -3.36 to -2.43)，and joint pain score(SMD=-3.11，95%CI -3.87 to -2.35) was significantly better than that of the control group(P<0.05).The incidence of adverse reactions in the observation group was significantly lower than that in the control group(P<0.05).Conclusion:The efficacy and safety of Guizhi Shaoyao Zhimu Decoction combined with western medicine in the treatment of AGA is significantly better than that of western medicine alone.However，due to the limitations of the quality and quantity of the included studies，more high-quality RCTs are needed to confirm the above conclusions. |
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