CAJ | 학술논문

目的：系统评价中药治疗重症肌无力的临床疗效。方法：计算机检索CNKI中国知网（总库）、维普数据库、PubMed、Cochrane图书馆，查找以中药治疗重症肌无力的随机对照试验。由两名评价者独立对纳入文献进行信息录入、质量评价。采用RevMan5.2软件进行Meta分析。结果：共纳入58个临床随机对照试验，包括4773例患者。纳入中文文献质量普遍不高，高质量文献有4篇，其余为低质量文献。结果显示：与西药组治疗重症肌无力临床疗效相比，中药复方治疗无统计学意义[RR=1.15，95%CI（0.94，1.41）]，中药复方联合西药治疗有统计学意义[RR=1.10，95%CI（1.03，1.18）]，中成药联合西药治疗有统计学意义[RR=1.17，95%CI（1.08，1.28）]。中药复方联合西药治疗重症肌无力不良反应（肌无力一过性加重、血糖增高、白细胞下降、血小板下降、胃肠反应）发生率低于单纯西药治疗组（P<0.05）。结论：现有有限证据表明，单用中药复方治疗重症肌无力临床疗效与西药组作用相似，但中药联合西药治疗重症肌无力较西药治疗更为有效，并能降低西药的副作用。并且中药组方中尤以黄芪应用为多。但上述结论尚需大样本高质量临床试验加以证实。
목적：계통평개중약치료중증기무력적림상료효。방법：계산궤검색CNKI중국지망（총고）、유보수거고、PubMed、Cochrane도서관，사조이중약치료중증기무력적수궤대조시험。유량명평개자독립대납입문헌진행신식록입、질량평개。채용RevMan5.2연건진행Meta분석。결과：공납입58개림상수궤대조시험，포괄4773례환자。납입중문문헌질량보편불고，고질량문헌유4편，기여위저질량문헌。결과현시：여서약조치료중증기무력림상료효상비，중약복방치료무통계학의의[RR=1.15，95%CI（0.94，1.41）]，중약복방연합서약치료유통계학의의[RR=1.10，95%CI（1.03，1.18）]，중성약연합서약치료유통계학의의[RR=1.17，95%CI（1.08，1.28）]。중약복방연합서약치료중증기무력불량반응（기무력일과성가중、혈당증고、백세포하강、혈소판하강、위장반응）발생솔저우단순서약치료조（P<0.05）。결론：현유유한증거표명，단용중약복방치료중증기무력림상료효여서약조작용상사，단중약연합서약치료중증기무력교서약치료경위유효，병능강저서약적부작용。병차중약조방중우이황기응용위다。단상술결론상수대양본고질량림상시험가이증실。
This study was aimed to assess the clinical efficacy of Chinese herbs for myasthenia gravis. Randomized controlled trials (RCTs) on Chinese medicine treatment of myasthenia gravis were systemically searched from the China National Knowledge Infrastructure (CNKI), Weipu Database, PubMed and Cochrane Library. The information was recorded and the methodological quality of the included trials was assessed by two reviewers independently. The RevMan 5.2 software was used in the meta-analysis. The results showed that 58 RCTs involving 4 773 patients were included. The quality of included Chinese literatures was generally not high. There were four high-quality literatures; and the rest were low-quality literature. The results of meta-analysis showed that compared with the effective rate of the western medicaltreatment group, there was no statistical difference between the Chinese medicine compound and the western medical treatment [RR = 1.15, 95%CI (0.94, 1.41)]. There was statistical difference between the western medical treatment plus the Chinese medicine compound group and the western medical treatment [RR = 1.10, 95%CI (1.03, 1.18)]. There was statistical difference between the western medical treatment plus the Chinese patent medicine group and the western medical treatment [RR = 1.17, 95%CI (1.08, 1.28)]. Compared with the western medical treatment group, the incidence of adverse reaction in the Chinese medicine compound plus the western medical treatment group was decreased obviously (P < 0.05). It was concluded that the current limited evidence showed that only using Chinese medicine had the similar clinical efficacy in the treatment of myasthenia gravis as western medicine. However, Chinese herbs combined with western medicine in the treatment of myasthenia gravis had better effects compared to western medicine. It can also reduce the side effects of western medicine. Especially astragalus was the most widely used herb in the Chinese medicine group. However, large-sample and high-quality clinical trials were required for further evidence.