中西医结合治疗浆细胞性乳腺炎临床疗效的Meta分析

Meta-Analysis of Clinical Efficacy of Combined Chinese and Western Medicine in the Treatment of Plasmacytoid Mastitis

摘要: 目的：评价中西医结合治疗浆细胞性乳腺炎(Plasma cell mastitis)的安全性和有效性。方法：计算机检索中国期刊全文数据库(CNKI)、万方数据库、维普中文期刊数据库(VIP)、Pubmed等数据库，并手工检索相关文献。检索时间为建库到2022年2月，纳入对照组为单纯西医治疗，观察组为在对照组基础上给予中医治疗的随机对照试验。由2名研究者按照提前制定好的纳排标准对文献进行筛选和资料的提取，并依照Cochrane Handbook风险偏倚评估工具5.1.0及R软件(4.1.2版)进行质量评估和meta分析。结果：符合纳入标准的随机对照试验(Randomised Controlled Trial)共13项，共1123例患者。Meta分析结果显示中西医结合治疗组与单纯西医治疗组的总有效率(OR = 4.57, 95% CI = [3.14~6.66], P < 0.0001)，随访半年复发率(OR = 0.46, 95% CI = [0.30, 0.69], P = 0.0002)，疼痛视觉模拟评分(SMD = −2.1996, 95% CI = [−3.0515, −1.3478], P < 0.0001)，提示差异均有统计学意义。不良反应发生率(OR = 0.64, 95% CI = [0.35, 1.16], P = 0.14)，差异无统计学意义。结论：中西医结合治疗浆细胞性乳腺炎疗效优于单纯西医治疗，并且中西医结合治疗可以减少该疾病的复发。本研究将为临床治疗浆细胞性乳腺炎提供可靠的循证医学证据。

Abstract: Objective: To evaluate the safety and efficacy of combining Chinese and Western medicine in the treatment of plasma cell mastitis (PCM). Methods: Computer search of China Journal Full Text Data-base (CNKI), Wanfang Database, VIP Chinese Journal Database (VIP), Pubmed and other databases, and manual search of related literature. The search time was from the establishment of the data-base to February 2022. This paper included randomized controlled trials in which the control group was treated with Western medicine alone and the observation group was treated with Chinese medicine given on top of the control group. The literature was screened and data extracted by two investigators according to predefined nadir criteria, and quality assessment and meta-analysis were performed according to the Cochrane Handbook Risk Bias Assessment Tool 5.1.0 and R soft-ware (version 4.1.2). Results: A total of 13 RCTs with a total of 1123 patients met the inclusion cri-teria. Meta-analysis showed that the overall effective rate was (OR = 4.57, 95% CI = [3.14~6.66], P < 0.0001), recurrence rate at six months follow-up (OR = 0.46, 95% CI = [0.30, 0.69], P = 0.0002), vis-ual analogue score of pain (SMD = −2.1996, 95% CI = [−3.0515, −1.3478], P < 0.0001), suggesting that the differences were all statistically significant. The incidence of adverse reactions was (OR = 0.64, 95% CI = [0.35, 1.16], P = 0.14), which had no statistically significant difference. Conclusion: Combination of Chinese and Western medicine is more effective than Western medicine alone in the treatment of plasmacytoid mastitis, and the combination of Chinese and Western medicine can re-duce the recurrence of the disease. This study will provide reliable evidence-based medical evi-dence for the clinical treatment of plasmacytoid mastitis.