| 凌洁,王慧,凌晓雅,等.中药复方治疗带状疱疹后遗神经痛的疗效及安全性的Meta分析[J].浙江中医药大学学报,2023,47(5):569-578. |
| 中药复方治疗带状疱疹后遗神经痛的疗效及安全性的Meta分析 |
| Meta-analysis of Effectiveness and Safety of Chinese Herbal Medicine Treatment for Postherpetic Neuralgia |
| DOI：10.16466/j.issn1005-5509.2023.05.021 |
| 中文关键词: 带状疱疹后遗神经痛 中药复方 随机对照试验 Meta分析 P物质 IL-6 TNF-α |
| 英文关键词: postherpetic neuralgia Chinese herbal compound randomized control trial Meta-analysis substance P IL-6 TNF-α |
| 基金项目:浙江省中医院曹毅名中医工作室(GZS2020022) |
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| 中文摘要: |
| [目的] 系统评价中药复方治疗带状疱疹后遗神经痛(postherpetic neuralgia，PHN)的有效性及安全性。 [方法] 计算机检索自建库至2022年4月国内外数据库公开发表的关于中药复方治疗PHN的临床随机对照试验(random control trials，RCT)。筛选文献并提取资料，采用Review Manager 5.4分析软件对结局指标进行Meta分析。[结果] 最终纳入43篇文献，均为中文文献，共3 493例受试对象。Meta分析显示，中药复方组在总有效率[优势比(odds ratio，OR)=5.02，95%置信区间(confidence interval，CI)(4.00，6.30)，P＜0.00001]、视觉模拟评分法(visual analogue scale，VAS)评分[标准化均数差值(standard mean difference，SMD)=-1.98，95%CI(-2.33，-1.63)，P＜0.00001]、匹兹堡睡眠质量量表(Pittsburgh sleep quality index，PSQI)评分[SMD=-1.71，95%CI(-2.71，-0.71)，P=0.0008]、P物质(substance P，SP)水平[SMD=-2.18，95%CI(-3.27，-1.08)，P＜0.0001]和白介素-6(interleukin-6，IL-6)水平[SMD=-4.92，95%CI(-7.29，-2.55)，P＜0.0001]方面均优于单纯西药组，且不受疗程限制。中药复方组的不良反应发生率优于单纯西药组[OR=0.50，95%CI(0.37，0.68)，P＜0.0001]，但亚组分析中疗程短于4周[OR=0.54，95%CI(0.24，1.23)，P=0.14]和超过4周[OR=0.24，95%CI(0.04，1.50)，P=0.13]差异无统计学意义。两组肿瘤坏死因子-α(tumor necrosis factor-α，TNF-α)水平差异无统计学意义[SMD=-0.63，95%CI(-2.17，0.91)，P=0.42]。[结论] 中药复方治疗PHN疗效显著，且安全性高。 |
| 英文摘要: |
| [Objective] To systematically review the efficacy and safety of traditional Chinese medicine for postherpetic neuralgia(PHN). [Methods] Through searching the random control trials(RCT) published in domestic and foreign databases from the establishment date of database to April 2022 for the Chinese herb treatment of PHN. Literature was sifted through and extracted， then it used Review Manager 5.4 to complete Meta-analysis. [Results] There were 43 RCT literature containing 3 493 subjects that met the criteria and were all in Chinese. The results of statistical analysis showed that the herbal compound group was superior to the pure western medicine group in total efficiency[odds ratio(OR)=5.02， 95% confidence interval(CI)(4.00，6.30)， P＜0.00001]， visual analogue scale(VAS) score[standard mean difference(SMD)=-1.98， 95%CI(-2.33，-1.63)， P＜0.00001]， Pittsburgh sleep quality index(PSQI) score[SMD=-1.71， 95%CI(-2.71，-0.71)， P=0.0008]， substance P(SP) levels[SMD=-2.18， 95%CI(-3.27，-1.08)， P＜0.0001]， interleukin-6(IL-6) levels[SMD=-4.92， 95% CI(-7.29，-2.55)， P＜0.0001]， and treatment course restrictions had no effect. The incidence of adverse reactions was lower in the herbal compound group than in the pure western medicine group[OR=0.50， 95%CI(0.37，0.68)， P＜0.0001]， but there was no significant difference in subgroup analysis between treatment course shorter than 4 weeks[OR=0.54，95%CI(0.24，1.23)，P=0.14] and treatment course longer than 4 weeks[OR=0.24，95%CI(0.04，1.50)，P=0.13]. The difference in tumor necrosis factor-α(TNF-α) levels between the two groups was not statistically significant[SMD=-0.63， 95%CI(-2.17， 0.91)， P=0.42]. [Conclusion] The combination of traditional Chinese medicine in the treatment of PHN has significant efficacy and good safety. |
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