摘要
目的:评价中医外治法治疗单纯疱疹病毒性角膜炎的临床有效性和安全性。方法:计算机检索1998年1月至2018年6月国内外数据库(中国学术期刊全文数据库、中国博士学位论文全文数据库、中国优秀硕士学位论文全文数据库、维普数据库、万方期刊数据库、Medline期刊全文数据库),按拟定标准筛选文献,对纳入文献依据Jadad量表和随机化隐藏评级进行质量评价和数据提取。用RevMan5.3统计软件进行统计分析。结果:共纳入17篇文献,1277例患者,其中治疗组658例799眼,对照组619例774眼。Meta分析结果显示,单纯或联合使用中医外治法治疗单纯疱疹病毒性角膜炎在总有效率(OR=4.06,95%CI[2.90,5.69])、总治愈率(OR=2.70,95%CI[2.16,3.39])、总复发率(OR=0.31,95%CI[0.20,0.49])、疗程(SMD=-2.02,95%CI[-2.86,-1.18])方面优于单纯西药治疗组,且差异有统计学意义。结论:中医外治法,主要为中药熏蒸和超声雾化法,治疗单纯疱疹病毒性角膜炎在总有效率、总治愈率、总复发率、疗程方面优于单纯西医药治疗组,且超声雾化法在疗程上更具优势。但目前此类文献方法学质量较低,复发率、疗程漏斗图显示欠对称,可能存在发表性偏倚。因此,期待设计严密规范的大样本、多中心、随机双盲对照研究进一步证实结论。
Objective:To evaluate the clinical efficacy and safety of external treatment of herpes simplex keratitis(HSK).Methods:Computer retrieval of domestic and foreign databases from January 1998 to June 2018(Chinese academic journal full-text database,Chinese doctoral thesis full-text database,China excellent master's thesis full-text database,VIP database,Wanfang journal database,Medline journal full-text database),the literature was screened according to the proposed criteria,and the quality of the included literature was evaluated and extracted based on the Jadad scale and the randomized hidden rating.Statistical analysis was performed using RevMan 5.3 statistical software.Results:A total of 17 literature were included,1277 patients,including 658 cases of 799 eyes in the treatment group and 619 cases of 774 eyes in the control group.Metaanalysis results showed that the total effective rate(OR=4.06,95%CI[2.90,5.69]),total cure rate(OR=2.70,95%CI[2.16,3.39]),total recurrence rate(OR=0.31,95%CI[0.20,0.49]),treatment course(SMD=-2.02,95%CI[-2.86,-1.18])of herpes simplex keratitis treated by external therapy of traditional Chinese medicine alone or in combination were better than those treated by western medicine alone,and the differences were statistically significant.Conclusion:The external treatment of traditional Chinese medicine is mainly fumigation of traditional Chinese medicine and ultrasonic nebulization.The total effective rate,total cure rate,total recurrence rate and course of treatment of herpes simplex keratitis are better than those of Western medicine alone,and the ultrasonic nebulization method has more advantages in the course of treatment.However,the methodological quality of the current literature is low.The recurrence rate and the course of treatment funnel chart show asymmetry,and there may be publication bias.Therefore,large-sample,multi-center,randomized,double-blind,controlled trials with tightly regulated specifications are expected to further confirm the conclusions.
作者
邹妙然
缪晚虹
俞莹
ZOU Miao-ran;MIAO Wan-hong;YU Ying(Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 210203,China)
出处
《中医药导报》
2019年第11期125-131,共7页
Guiding Journal of Traditional Chinese Medicine and Pharmacy
基金
国家自然科学基金青年基金项目(81704124),项目名称:基于CD4+CD25+调节性T细胞在单纯疱疹病毒性角膜炎诱导复发中的作用研究益气解毒方的作用机制
