Traditional Chinese Medicine for Myasthenia Gravis: A Reevaluation on Systematic Review/Meta-analysis

HUANG Chunhua; LIU Liting; RAO Wangfu

doi:10.13288/j.11-2166/r.2019.15.008

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Traditional Chinese Medicine for Myasthenia Gravis: A Reevaluation on Systematic Review/Meta-analysis

更新时间：2021-11-10

- Traditional Chinese Medicine for Myasthenia Gravis: A Reevaluation on Systematic Review/Meta-analysis
- Journal of Traditional Chinese Medicine Vol. 60, Issue 15, Pages: 1294-1298(2019)
- 作者机构：
  
  1. 江西中医药大学附属医院
  2. 江西中医药大学研究生院
  3. 江西中医药大学附属医院江西中医药大学研究生院
- 作者简介：
- 基金信息：
- DOI：10.13288/j.11-2166/r.2019.15.008
  CLC： R277.7
- Published：2019
- 稿件说明：
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[1]黄春华,刘丽婷,饶旺福.中医药治疗重症肌无力系统评价/Meta分析的再评价[J].中医杂志,2019,60(15):1294-1298+1335.

HUANG Chunhua, LIU Liting, RAO Wangfu. Traditional Chinese Medicine for Myasthenia Gravis: A Reevaluation on Systematic Review/Meta-analysis[J]. Journal of Traditional Chinese Medicine2019, 60(15): 1294-1298.
[1]黄春华,刘丽婷,饶旺福.中医药治疗重症肌无力系统评价/Meta分析的再评价[J].中医杂志,2019,60(15):1294-1298+1335. DOI： 10.13288/j.11-2166/r.2019.15.008.

HUANG Chunhua, LIU Liting, RAO Wangfu. Traditional Chinese Medicine for Myasthenia Gravis: A Reevaluation on Systematic Review/Meta-analysis[J]. Journal of Traditional Chinese Medicine2019, 60(15): 1294-1298. DOI： 10.13288/j.11-2166/r.2019.15.008.

摘要

目的对中医药治疗重症肌无力的系统评价/Meta分析的结论可靠程度进行再评价研究。方法计算机检索中国知网、维普网、万方数据、中国生物医学数据库、PubMed、EMBase、Cochrane Library数据库

查找中医药治疗重症肌无力的系统评价/Meta分析的文献

检索时限均为从建库至2018年9月30日

分别采用AMSTAR量表、GRADE工具对纳入的研究进行方法学质量评价、结局指标证据质量分级

并对主要结局指标进行描述分析。结果共纳入7篇系统评价/Meta分析

有28个结局指标。其中6篇采用中药联合西药与单纯西药治疗进行比较

1篇采用单纯中药与单纯西药治疗进行比较。AMSTAR量表评分显示

3篇分值在11～16分

属于中等质量; 4篇分值在17～22分

属于高质量。GRADE分级显示

23个结局指标证据质量为低或极低

仅有5个为中级质量

主要体现在复发率、中医证候积分、不良反应方面。描述分析结果显示

中医药治疗重症肌无力

可提高总有效率

降低临床绝对评分、临床相对评分

减少复发率、不良反应发生率（P <0. 05或P <0. 01）。结论中医药治疗重症肌无力系统评价/Meta分析的方法学质量为中高等级

但结论的证据强度较低。现有证据表明

中医药联合西药在治疗重症肌无力上可能有协同增效的作用。

Abstract

Objective To conduct a reevaluation study on systematic review/Meta-analysis of traditional Chinese medicine（TCM） treatment of myasthenia gravis（MG）

in order to evaluate the bias and the reliability of the conclusion. Methods We comprehensively searched China National Knowledge Infrastructure（CNKI）

VIP database

WanFang database

Chinese Biology Medicine（CBM）

PubMed

Embase

The Cochrane Library for literature on systematic review/Meta-analysis of TCM treatment of MG from the establishment time of databases to September 30 th

2018. The literature were evaluated in terms of methodological quality evaluation

outcome index evidence quality grading. Descriptive analysis was conducted to primary outcome index. Results A total of 7 SRs/Meta-analysis were included with 28 outcomes index. 6 papers compared the efficacy of TCM combined with western medicine between western medicine alone in treating MG. One systematic review compared the efficacy of TCM alone and western medicine alone. The AMSTAR scale score showed that there were 3 papers with a total score of 11-16

which was of medium quality. 4 papers with a total score was between 17 and 22 points

which was of high quality. GRADE grading results showed that evidences of 23 outcome index were of low or extremely low quality

and only 5 outcomes were of intermediate quality

mainly reflected in the recurrence rate

TCM syndrome scores

adverse reactions. Descriptive analysis showed that TCM treatment of MG can improve the total effective rate

reduce the clinical absolute score

clinical relative score

reduce the recurrence rate

the incidence of adverse reactions（P < 0. 05 or P < 0. 01）.Conclusion The systematic review/Meta-analysis of methodological quality of TCM treatment of MG is medium to high

but the evidence strength of the conclusion is low. The available evidence indicates that TCM combined with western medicine may have synergistic effects in the treatment of MG.

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