摘要
目的：系统评价中医辨证论治多发性硬化（MS）的临床疗效。方法：全面检索中国期刊全文数据库、维普中文科技期刊全文数据库、中国生物医学文献服务系统、万方医药期刊数据库、Pub Med、Cochrane图书馆等数据库。中文检索词以＂多发性硬化＂和＂中药或针灸或中西医结合＂为并列检索词,英文检索词为＂multiple sclerosis or MS＂AND＂traditional Chinese medicine or herb or herbal or acupuncture or combined traditional Chinese and western medicine＂检索中医辨证治疗MS的随机对照临床试验文献,时间区间设定为2000年1月1日—2016年10月30日。按照Cochrane系统评价手册推荐的简单评价法,评价纳入研究的方法学质量。软件版本为Review Manger 5.3,结局效应指标分别为EDSS评分（EDSS）、有效率、复发次数、临床症状评分、神经功能体征评分。结果：最终纳入16个随机对照临床试验,共906例研究对象。所纳入的研究中有13项研究报道了EDSS评分,纳入统计的为11项,试验组与对照组比较,MD及95%CI为-0.96（-1.50,-0.41）,P〈0.05,有统计学差异;有12项研究观察了有效率,11项研究可提取有效数据,OR值为4.93,95%CI为（3.05,7.96）,P〈0.001,统计学有显著差异;有3项研究对患者进行了复发次数评价,MD及95%CI为-0.43（-0.67,-0.19）,P〈0.05,有统计学差异;有8项研究观察了临床症状评分,7项可提取有效数据,MD及95%CI为-1.09（-3.41,1.23）,P〉0.05,统计学无差异;有4项研究观察了神经功能体征评分,试验组与对照组比较,MD及95%CI为-1.86（-4.70,0.97）,P〉0.05,统计学无差异。结论：中医辨证论治结合西药治疗MS相对于单纯西药治疗,提高了其有效率,减少MS的复发次数,改善神经功能缺损。
Objective： To evaluate the efficacy of evidence-based therapies of traditional Chinese medicine in treating multiple sclerosis（ MS）. Methods： The retrieval words of＂multiple sclerosis or MS＂and＂traditional Chinese medicine or herb or herbal or acupuncture＂were searched in China National Knowledge infrastructure（ CNKI）,Chinese VIP database,Chinese Biomedical Literature Database（ CBM）,Wan Fang Database,Pubmed and the Cochrane Library through computer. The time frame was ranged from January 1,2000 to October 30,2016. Using the basic methods referenced by the Cochrane system,the methodological quality of the research was evaluated. Review Manger 5. 3. was selected as the software edition. Effective rate,Kurtzke Extended Disability Status Scale（ EDSS）,clinical score,neurological score,and recurrent frequency were chosen as the markers of outcome variables.Results： Eventually 16 randomized control trials（ RCTs） were included with 906 cases. Experimental group compared with control group： EDSS was reported in 13 studies,the data could be extracted from 11 ones,MD and 95% CI were-0. 96（-1. 50,-0. 41）,P〈0. 05,which had significant difference in statistics. Efficiency was observed in 12 participants of the research in the studies,effective data could be extracted from 11 ones,the OR value was 4. 93,95% CI was（ 3. 05,7. 96）,P〈0. 001,which had significant difference in statistics. The recurrent frequency was evaluated in 3 studies,MD and 95% CI were-0. 43（-0. 67,-0. 19）,P〈0. 05,which had difference in statistics. The clinical symptom score was observed in 8 studies,the data could be extracted effectively from 7 ones,MD and 95% CI were-1. 09（-3. 41,1. 23）,P〈0. 05,which had no significant difference in statistics. The neurologic symptoms score was observed in 4 studies,MD and 95% CI were-1. 86（-4. 70,0. 97）,P〈0. 05,which had no significant difference in statistics. Conclusion： Compared to the simplex western medicine treatment in MS,evidence-based therapies of traditional Chinese medicine could significantly improve the nerve function defect,promote the efficiency,and reduce the recurrence rate.
作者
马金昀
张爱明
叶妮
马成勇
程晓东
MA Jinyun;ZHANG Aiming;YE Ni;MA Chengyong;CHENG Xiaodong(1. Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China ;2. Wu - jing Hospital, Shanghai 200241, China; 3. Shanghai University of Traditional Chinese Medicine ,Shanghai 201203 ,Chin)
出处
《辽宁中医杂志》
CAS
2018年第3期459-466,共8页
Liaoning Journal of Traditional Chinese Medicine
基金
国家自然科学基金面上项目(81673669)
国家自然科学基金青年项目(81703782)
上海市中医药新兴交叉学科“中医临床免疫学”建设项目(30304113598)
上海中医药大学中医学高峰学科建设项目(30304114323)
关键词
辨证论治
中药
针灸
多发性硬化
随机对照试验
META分析
evidence - based therapy
traditional Chinese medicine
acupuncture
multiple sclerosis
randomized controlledtrial
Meta - analysis
