来源：风湿病与关节炎,2020,9（11）:28-33,38.

中西医结合治疗系统性红斑狼疮的Meta分析（循证研究）

张绍琴¹，贾　敏²，蔡　鑫¹

　　【摘　要】目的：系统评价中西医结合治疗系统性红斑狼疮的疗效与安全性。方法：计算机检索中国知网（CNKI）、万方（Wanfang）、维普（VIP）、中国生物医学文献服务系统、Pubmed、Cochrane图书馆等数据库中中西医结合治疗系统性红斑狼疮的临床随机对照试验文献，检索时间为数据库建立至2019年11月，运用Rev Man 5.3软件进行Meta分析。结果：共纳入19篇文献，1518例患者，其中试验组749例，对照组769例。Meta分析结果显示，中西医结合治疗系统性红斑狼疮在总有效率（OR = 4.31，95%CI = ［3.19，5.82］，P < 0.000 01），红细胞沉降率（ESR）（MD = -7.75，95%CI = ［-12.92，-2.58］，P = 0.003），C-反应蛋白（CRP）（MD = -8.69，95%CI = ［-13.09，-4.29］，P = 0.000 1），系统性红斑狼疮活动指数（SLE-DAI）（MD = -1.88，95%CI = ［-2.33，-1.43］，P < 0.000 01），抗ds-DNA抗体（MD = -0.62，95%CI = ［-1.09，-0.16］，P = 0.009）等方面优于对照组，差异均有统计学意义；但24 h尿蛋白（UTP/24 h）（MD = -0.93，95%CI = ［-1.97，0.12］，P = 0.08）与对照组比较，差异无统计学意义。结论：中西医结合治疗系统性红斑狼疮可提高总有效率，改善ESR、CRP、SLE-DAI、抗ds-DNA抗体，在改善UTP/24 h方面2组疗效相当。但是，由于纳入研究质量的限制，本研究所得结论尚需要更多高质量临床试验进一步验证。

　　【关键词】　系统性红斑狼疮；中西医结合；疗效；Meta分析

Meta-analysis of Systemic Lupus Erythematosus Treated with Integrated Chinese and Western Medicine

ZHANG Shao-qin,JIA Min,CAI Xin

　　【ABSTRACT】Objective:To systematically evaluate the efficacy and safety of integrated traditional Chinese and Western medicine in the treatment of systemic lupus erythematosus.Methods:Databases such as CNKI,Wanfang,VIP,SinoMed,PubMed and Cochrane Library were searched for the randomized controlled clinical trials of integrated traditional Chinese and Western medicine in the treatment of systemic lupus erythematosus（SLE）.The retrieval time was from the establishment of the database to November 2019.The Meta-analysis was performed using the software Rev Man 5.3.Results:A total of 19 articles including 1518 patients were included,including 769 cases in the control group and 749 cases in the experimental group.Meta-analysis showed that the total effective rate（OR = 4.31,95%CI = ［3.19,5.82］,P < 0.000 01）,erythrocyte sedimentation rate（ESR）（MD = -7.75,95%CI = ［-12.92,-2.58］,P = 0.003）,C-reactive protein（CRP）（MD = -8.69,95%CI = ［-13.09,-4.29］,P = 0.000 1）,the systemic lupus erythematosus activity index（SLE-DAI）（MD = -1.88,95%CI = ［-2.33,-1.43］,P < 0.000 01）,anti ds-DNA titer（MD = -0.62,95%CI = ［-1.09,-0.16］,P = 0.009）were better than those of the control group,and the differences were statistically significant;but compared with the control group,the difference of 24-hour urinary protein（UTP/24 h）（MD = -0.93,95%CI = ［-1.97,0.12］,P = 0.08）was not statistically significant.Conclusion:Integrated Chinese and Western medicine can improve the total effective rate of systemic lupus erythematosus,improve ESR,CRP,SLE-DAI and ds-DNA.The two groups have the same effect in improving UTP/24 h.Due to the limitation of the quality of included studies,the conclusion of this study needs to be further verified by more high-quality randomized clinical trials.

　　【Keywords】 systemic lupus erythematosus;integrated Chinese and Western medicine;efficacy;Meta analysis