中药联合糖皮质激素治疗系统性红斑狼疮系统评价与Meta分析OA

Objective:This study used a meta-analysis to systematically evaluate the clinical efficacy and safety of Chinese herbal medicine combined with glucocorticoids in the treatment of systemic lupus erythematosus(SLE).Methods:We searched CNKI,VIP and Wanfang,CBM and the PubMed database to collect RCTs on the combined treatment of SLE with integrated traditional Chinese and Western medicine,we screened the literature according to pre-established inclusion and exclusion criteria and outcome indicators,and performed a Meta-analysis using RevMan 5.3 software.The primary outcome indicator is the clinical effective rate,and secondary outcome indicators include the SLE disease activity score,the incidence of adverse reactions,and laboratory examination indicators[peripheral blood white blood cell count,complement C3 level].Results:A total of 24 RCTs involving 2074 patients were included.The Meta-analysis results showed that compared with the control group,combined treatment with traditional Chinese and Western medicine for SLE significantly improved clinical efficacy(RR=1.17,95%CI:1.13～1.22,P<0.000 01),reduced the SLE disease activity score(MD=-1.83,95%CI:-2.09～-1.58,P<0.000 01),increased the peripheral blood white blood cell count(MD=0.76,95%CI:0.58～0.94,P<0.000 01),and elevated complement C3 levels(MD=0.11,95%CI:0.05,0.17,P=0.0003).The incidence of adverse drug reactions in the combined treatment group was significantly lower than that in the control group(RR=0.43,95%CI:0.25～0.72,P<0.000 01).Conclusion:Compared with glucocorticoid monotherapy,the combination of traditional Chinese medicine and glucocorticoids for the treatment of SLE can significantly improve the clinical effective rate,reduce the SLE disease activity score,increase the peripheral blood white blood cell count and complement C3 level,and significantly decrease the incidence of adverse drug reactions.However,limited by factors such as the varying quality of the included studies and the relatively short follow-up periods,more high-quality,long-term follow-up RCTs are still needed to further validate the conclusions of this study.