对于甲状腺功能障碍的Jiawei-Xiaoyao-San的有效性和潜在机制:系统性审查
Wenxin Ma1, Xiaowen Zhang1, Ruotong Zhao2
1Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.
Frontiers in endocrinology
|October 2, 2023
概括
贾威-肖亚-桑 (JWXYS) 与抗甲状腺药物 (ATD) 相结合,可以通过提高疗效和减少不良事件来改善甲状腺功能障碍治疗. 用JWXYS单疗法只建议患者不能容忍ATDs.
科学领域:
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
- 综合医学是一个整体医学.
背景情况:
- 甲状腺功能障碍是一种常见的内分泌疾病,通常用抗甲状腺药物 (ATD) 进行治疗.
- 传统中国医学 (TCM),如贾威 - 肖亚 - 桑 (JWXYS),被探索为辅助或替代疗法.
- 评估JWXYS在甲状腺功能障碍治疗中的疗效和机制对于基于证据的实践至关重要.
研究的目的:
- 与ATD相比,评估JWXYS作为甲状腺功能障碍的辅助或单一疗法的有效性.
- 研究JWXYS在甲状腺功能障碍症中的作用背后的潜在机制.
- 综合来自随机对照试验 (RCT) 和其他研究设计的证据.
主要方法:
- 在8个数据库和3个试验注册表中进行了系统的文献搜索,直到2023年5月.
- 随机对照试验 (RCT) 被包含在使用RevMan 5.4和Stata 14.0.0的元分析中.
- 使用Cochrane偏差风险 (ROB) 工具和GRADE工具进行了质量评估;从病例报告和药理学研究中得出的发现得到了总结.
主要成果:
- 分析了13项涉及979名参与者的RCT,大多数研究显示至少在一个ROB领域存在高偏差风险.
- 与ATD相比,JWXYS加上ATD显示出潜在的益处,包括改善甲状腺激素水平 (较低的FT3,FT4;更高的TSH),更高的TCM综合征有效率,缩小囊大小,较低的甲状腺素受体抗体,以及较少的不良事件.
- 与减少ATD剂量相结合的JWXYS也导致较少的不良事件. 病例报告表明,由于严重的不良事件或ATD复发而寻求JWXYS单疗法. 药理学研究表明,JWXYS调节免疫平衡,甲状腺功能和氧化应激.
结论:
- JWXYS可能会提高甲状腺功能障碍症的ATD有效性,特别是在缓解症状和减少不良事件方面.
- 通常不建议使用单一JWXYS治疗,除非患者不能容忍ATD.
- 由于包含的研究中存在偏差的高风险,研究结果应谨慎解释;需要进一步严格的药理学研究.
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