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目的:探讨中药联合甲氨蝶呤治疗类风湿关节炎的临床疗效。方法:搜索检索Pubmed与Embase外文数据库,CNKI及Wanfang中文数据库,纳入中药联合甲氨蝶呤与单纯甲氨蝶呤治疗类风湿关节炎的随机对照试验(RCT)文献,用Cochrane系统评价手册进行质量评分,对总有效率、血沉(ESR)、C反应蛋白(CRP)、类风湿因子(RF)进行Meta分析。结果:共纳入5篇RCT文献进入对照研究,Meta分析显示,中药联合甲氨蝶呤治疗组总疗效优于单纯甲氨蝶呤对照组(P<0.05),并且治疗组降低CRP、ESR、RF效果均优于对照组(P<0.05)。结论:对比单纯使用甲氨蝶呤,联合中药治疗类风湿关节炎有更好的临床疗效,且没有增加不良反应,适合临床推广,但由于纳入文献质量不高,需要进一步开展高质量随机对照试验。
Objective: To investigate the clinical efficacy of traditional Chinese medicine combined with methotrexate in the treatment of rheumatoid arthritis. Methods: Randomized controlled trials (RCTs) were performed to search Pubmed and Embase databases, CNKI and Wanfang Chinese databases for the treatment of rheumatoid arthritis with combination of methotrexate and methotrexate. The Cochrane review manual Score, Meta-analysis was performed on the total effective rate, ESR, CRP, and rheumatoid factor (RF). Results: A total of 5 RCTs were enrolled in the control study. The Meta analysis showed that the combined treatment with MTX and methotrexate was superior to methotrexate alone (P <0.05), and the CRP, ESR, RF The results were better than the control group (P <0.05). Conclusion: Compared with the simple use of methotrexate, combined with traditional Chinese medicine treatment of rheumatoid arthritis has a better clinical efficacy, and no adverse reactions, suitable for clinical promotion, but due to the quality of the included literature, the need for further high-quality randomized controlled trials .