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中成药复方制剂联合常规治疗用于寻常型银屑病疗效与安全性的贝叶斯网状Meta分析
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| 篇名： | 中成药复方制剂联合常规治疗用于寻常型银屑病疗效与安全性的贝叶斯网状Meta分析 |
| TITLE： | Bayesian Network Meta-analysis of Therapeutic Efficacy and Safety of Chinese Patent Medicine Compound Preparation Combined with Conventional Therapy for Psoriasis Vulgaris |
| 摘要： | 目的：系统评价中成药复方制剂联合常规治疗用于寻常型银屑病疗效与安全性的差异，为临床用药提供循证参考。方法：计算机检索中国知网、万方数据、维普网、中国生物医学文献数据库、PubMed、Cochrane图书馆、WebofScience等数据库，收集不同中成药复方制剂联合常规治疗对比常规治疗用于寻常型银屑病的随机对照试验（RCT），检索时限均为各数据库建库起至2020年2月。筛选文献，提取资料后采用Cochrane系统评价员手册5.1推荐的偏倚风险评估工具对纳入文献质量进行评价，采用Stata15.0软件、Addis1.16.6软件以及马尔科夫链-蒙特卡洛方法进行贝叶斯网状Meta分析。结果：共纳入41项RCT，共计4122例患者；涉及复方青黛胶囊、消银颗粒、克银丸、郁金银屑片、常规治疗等5种干预措施。网状Meta分析结果显示，在提高总有效率方面，与常规治疗比较，4种不同中成药复方制剂联合常规治疗均可显著提高患者的总有效率（P＜0.05）；网状Meta排序结果为克银丸联合常规治疗＞复方青黛胶囊联合常规治疗＞消银颗粒联合常规治疗＞郁金银屑片联合常规治疗＞常规治疗。在降低治疗后银屑病面积和严重程度指数（PASI）评分方面，与常规治疗比较，克银丸、消银颗粒联合常规治疗均显著可降低患者的PASI评分（P＜0.05），而复方青黛胶囊、郁金银屑片联合常规治疗与常规治疗比较，差异均无统计学意义（P＞0.05）；网状Meta排序结果为消银颗粒联合常规治疗＞克银丸联合常规治疗＞复方青黛胶囊联合常规治疗＞郁金银屑片联合常规治疗＞常规治疗。在降低血清炎性因子水平方面，与常规治疗比较，复方青黛胶囊、消银颗粒联合常规治疗均可显著降低患者的白细胞介素17水平（P＜0.05），而克银丸、郁金银屑片联合常规治疗与常规治疗比较，差异均无统计学意义（P＞0.05）；网状Meta排序结果为消银颗粒联合常规治疗＞复方青黛胶囊联合常规治疗＞郁金银屑片联合常规治疗＞克银丸联合常规治疗＞常规治疗。在安全性方面，4种中成药复方制剂联合常规治疗与常规治疗的不良反应发生率比较，差异均无统计学意义（P＞0.05）；网状Meta排序结果为复方青黛胶囊联合常规治疗＞消银颗粒联合常规治疗＞克银丸联合常规治疗＞常规治疗＞郁金银屑片联合常规治疗。结论：与常规治疗比较，加用4种中成药复方制剂均可提高寻常型银屑病血热证患者的疗效，以克银丸最佳；在降低患者皮损程度及血清炎性因子方面，以消银颗粒最佳；加用4种中成药复方制剂的安全性均较好，以复方青黛胶囊最佳。 |
| ABSTRACT： | OBJECTIVE：To systematically evaluate the therapeutic efficacy and safety of Chinese patent medicine compound preparation combined with conventional therapy for psoriasis vulgaris ，and to provide evidence-based reference for clinical drug use. METHODS ：Retrieved from CNKI ，Wanfang database ，VIP，CBM，PubMed，the Cochrane Library and Web of Science ， RCTs about Chinese patent medicine compound preparation combined with conventional therapy versus conventional therapy in the treatment of psoriasis vulgaris were collected during the inception to Feb. 2020. After literature retrieval and data extraction ，the quality of the included studies was evaluated with risk bias assessment tool recommended by the Cochrane evaluation manual handbook 5.1. Bayesian network Meta-analysis was perfor med by using Stata 15.0 software，Addis 1.16.6 software and Markov Chain Monte Carlo method. RESULTS ：A total of 41 RCTs were included ，involving 4 122 patients. 5 kinds of interven- tion measures included Compound qingdai capsule ，Xiaoyin SF-010） granule， Keyin pill ，Yujin yinxie tablet and conventional therapy. Results of network Meta-analysis showed that in terms of improving the total effective rate ， compared with conventional therapy ，4 kinds of Chinese patent medicine compound preparations combined with conventional therapy could significantly improve the total effective rate （P＜0.05）；the results of network Meta-analysis were as follows ：Keyin pill combined with conventional therapy ＞Compound qingdai capsule combined with conventional therapy ＞Xiaoyin granule combined with conventional therapy ＞Yujin yinxie tablet combined with conventional therapy ＞conventional therapy. In terms of reducing psoriasis area and severity index （PASI）score after treatment ，compared with conventional therapy ，Keyin pill and Xiaoyin granule combined with conventional therapy could significantly reduce the PASI score （P＜0.05），while Compound qingdai capsule and Yujin yinxie tablet combined with conventional treatment had no significant difference （P＞0.05）；the results of network Meta-analysis showed that Xiaoyin granule combined with conventional therapy ＞Keyin pill combined with conventional therapy ＞ Compound qingdai capsule combined with conventional therapy ＞Yujin yinxie tablet combined with conventional therapy ＞ conventional therapy. In terms of reducing serum inflammatory factor level ，compared with conventional therapy ，Compound qingdai capsule and Xiaoyin granule combined with conventional therapy could significantly reduce the level of IL- 17（P＜0.05）， but Keyin pill and Yujin yinxie tablet combined with conventional therapy had no significant difference （P＞0.05）；the results of network Meta-analysis showed that Xiaoyin granule combined with conventional therapy ＞Compound qingdai capsule combined with conventional therapy ＞Yujin yinxie tablet combined with conventional therapy ＞Keyin pill combined with conventional therapy＞conventional therapy. In terms of safety ，there was no statistical significance in the incidence of ADR between 4 kinds of Chinese patent medicine combined with conventional therapy and conventional therapy （P＞0.05）；the results of network Meta-analysis showed that Compound qingdai capsule combined with conventional therapy ＞Xiaoyin granule combined with conventional therapy ＞Keyin pill combined with conventional therapy ＞conventional therapy ＞Yujin yinxie tablet combined with conventional therapy . CONCLUSIONS ：Compared with conventional therapy ，additional use of 4 kinds of Chinese patent medicine compound preparations can improve the curative effect of psoriasis vulgaris patients with blood heat syndrome ，and Keyin pill is the best ；Xiaoyin granule is the best in reducing the degree of skin lesions and serum inflammatory factors ；additional use of 4 kinds of Chinese patent medicine compound preparations show good safety ，and Compound qingdai capsule is the best. |
| 期刊： | 2021年第32卷第06期 |
| 作者： | 蔺莉，闫小宁，李文彬，赵一丁 |
| AUTHORS： | LIN Li，YAN Xiaoning ，LI Wenbin ，ZHAO Yiding |
| 关键字： | 中成药复方制剂；寻常型银屑病；贝叶斯网状Meta分析；疗效；安全性 |
| KEYWORDS： | Chinese patent medicine compound preparation ；Psoriasis vulgaris ；Bayesian network Meta-analysis ；Therapeutic |
| 阅读数： | 409 次 |
| 本月下载数： | 9 次 |
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