来源：风湿病与关节炎,2019,8（1）:36-40,45.

乌头汤联合常规西药治疗类风湿关节炎随机对照试验的Meta分析（循证研究）

兰维娅¹，唐　芳²，马武开²，卢向阳¹，陈琳英¹，李　宇¹，蒋　总¹，樊　梅¹，蔡　鑫¹，董龙聪¹，邓路达¹

　　【摘　要】目的：探讨乌头汤联合西药治疗类风湿关节炎的临床疗效，为其临床治疗及研究提供参考及循证医学支持。方法：计算机检索中国知网（CNKI）、万方（WANFANG DATA）、维普（VIP）、The Cochrane图书馆、中国生物医学文献数据库（CBM）等数据库，选取以乌头汤及其联合疗法治疗类风湿关节炎临床随机对照试验，检索时间为建库至2018年6月。由2名研究员独立筛选文献，提取文献资料及评估偏倚风险，并采用RevMan 5.3软件对数据进行分析。结果：共纳入11篇随机对照试验文献，总样本量为890例，其中试验组448例，对照组442例。Meta分析结果显示：乌头汤联合西药能提高疗效（RR = 1.31，95%CI = ［1.21，1.41］，P < 0.000 01），且乌头汤联合西药在红细胞沉降率（WMD = -1.08，95%CI =［-1.45，-0.70］，P < 0.000 1）、C-反应蛋白（WMD = -1.23，95%CI = ［-1.89，-0.58］，P = 0.000 2）、类风湿因子（WMD = -13.76，95%CI =［-24.32，-3.19］，P = 0.01）等指标改善方面均优于常规西药。纳入的文献有8篇提及不良反应。结论：乌头汤联合西药治疗类风湿关节炎可以进一步提高临床疗效，但由于纳入研究样本量小且质量较低，仍需要高质量、大样本的随机对照试验加以证实。

　　【关键词】　关节炎，类风湿；乌头汤；Meta分析

Meta-analysis of Randomized Controlled Trials of Treating Rheumatoid Arthritis with Wutou Tang（乌头汤）Combined with Western Medicine

LAN Wei-ya,TANG Fang,MA Wu-kai,LU Xiang-yang,CHEN Lin-ying,LI Yu,JIANG Zong,FAN Mei,CAI Xin,DONG Long-cong,DENG Lu-da

　　【ABSTRACT】Objective:To explore the clinical efficacy of Wutou Tang（乌头汤）combined with western medicine in the treatment of rheumatoid arthritis,and to provide reference and evidence-based medical support for its clinical treatment and research.Methods:The databases of CNKI,WANFANG DATA,VIP,The Cochrane Library and CBM were searched by computer for the randomized controlled clinical trials of treating rheumatoid arthritis with Wutou Tang or its combination therapy.The searching time was from the establishment of those databases to June 2018.Two researchers independently screened and extracted the literature,and assessed the bias risk.Software RevMan 5.3 was used to analyzethe data.Results:A total of 11 randomized controlled trials were included,including 890 sample cases,among which 448 cases were in the experimental group and 442 cases were in the control group.According to meta-analysis,Wutou Tang combined with western medicine could improve the efficacy（RR = 1.31,95%CI =［1.21,1.41］, P < 0.000 01）,and that Wutou Tang combined western medicine could improve ESR（WMD = -1.08,95%CI =［-1.45,-0.70］,P < 0.000 1）,C-reactive protein（WMD = -1.23,95% CI =［-1.89,-0.58］, P = 0.000 2）and Rheumatic factor（WMD = -13.76,95%CI = ［-24.32,-3.19］, P = 0.01）better than the western medicine group.Adverse reactions were mentioned in eight articles.Conclusion:Wutou Tang combined with western medicine can further improve the clinical efficacy for rheumatoid arthritis,but high quality and large sampled randomized controlled trials are still needed to confirm the study.

　　【Keywords】 arthritis,rheumatoid;Wutou Tang（乌头汤）;Meta-analysis