陈瑶;曾雪扬;刘涤非;谭小玉;蔡先明;杨丰文;廖星;孙凤;谢雁鸣;
CHEN Yao;ZENG Xue-yang;LIU Di-fei;TAN Xiao-yu;CAI Xian-ming;YANG Feng-wen;LIAO Xing;SUN Feng;XIE Yan-ming;Institute of Public Health,Peking University;Center for Evidence Based Medical and Clinical Research,Peking University;Centre for Evidence-Based Medicine,Tianjin University of Traditional Chinese Medicine;Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences;

• 1:北京大学公共卫生学院
• 2:北京大学循证医学中心
• 3:天津中医药大学循证医学中心
• 4:中国中医科学院中医临床基础医学研究所

摘要(Abstract)：

该研究通过全面梳理中医药领域已发表的网状Meta分析(NMA)的系统综述,介绍NMA在中医药领域的应用现状,并探讨NMA在中医药领域的应用价值。系统检索中国知网(CNKI)、万方数据库、Sino Med、维普网、Embase、PubMed和Cochrane Library,并手动检索既往文献参考文献列表,全面收集中医药主题下的NMA文献,提取文献的基本信息和研究设计信息。使用AMSTAR量表对文献方法学质量进行评估,使用PRISMA-NMA核查清单衡量报告规范程度。最终,共纳入122篇文献,其中中文80篇,英文42篇。结果显示目前中医药领域已发表的网状Meta分析主要涉及癌症、骨关节疾病、心血管疾病、呼吸系统疾病、精神类疾病和消化系统疾病这六类疾病;比较的干预措施大致分为三类,中药注射剂、中成药或方剂和针灸等物理疗法;有近1/3的研究干预方案为中西医结合治疗。整体方法学质量等级为中等,亚组分析结果显示英文文献方法学质量显著高于中文文献,2015年后发表的文献质量高于2015年及之前发表的文献。整体报告质量一般,尤其在方法和结果报告方面有待提高。NMA突破了传统Meta分析仅能对2个干预措施比较的限制,与中医药复杂的"同病异治"特点更加契合。结果提示目前中医药领域的NMA应用尚处于发展阶段,整体方法学质量中等,在方法和结果部分的报告规范程度有待提高。
To introduce the application status of network Meta-analysis( NMA) in the field of traditional Chinese medicine,and to discuss the application value of NMA in the field of traditional Chinese medicine,this study comprehensively reviewed the systematic reviews with application of NMA in the field of traditional Chinese medicine. CNKI,Wan Fang,Sino Med,VIP,Embase,PubMed and Cochrane Library and the reference list of previous studies were searched. The AMSTAR scale was used to evaluate the quality of literature methodology,and PRISMA-NMA checklist was used to measure the degree of report specification. Overall,122 articles were included,including 80 in Chinese and 42 in English. The included studies centered on cancer,bone and joint disease,cardiovascular disease,respiratory disease,mental disease and digestive disease. Additionally,the intervention can be categorized into three groups,traditional Chinese medicine injection,oral Chinese medicine or prescription,and traditional physical therapy including acupuncture.Nearly one-third of the researches' intervention program is aimed at comparing the effect of Chinese and Western combined therapy and monotherapy. The overall methodology quality grade is medium and the report quality is average,with methodology reporting and result reporting especially need to be improved. The subgroup analysis shows that the methodology quality of the English literatures is evidently higher than Chinese literatures,and the quality of the literatures published after 2015 is higher than those published in or before 2015.This study indicates that the NMA can compare multiple treatments simultaneously,which accords with characteristics of the clinical practice in traditional Chinese medicine that is complex and individual. NMA in the field of traditional Chinese medicine is still in the process of development. With higher level of quality control and reporting as well as the improvement of the statistical methodology and the accumulation of original researches,NMA application in the field of traditional Chinese medicine will be promising.

关键词(KeyWords)： 中医药;网状Meta分析;现状分析;质量评价;报告规范;应用价值
traditional Chinese medicine;network Meta-analysis;descriptive analysis;quality assessment;reporting checklist;application value

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金项目(71673003,81774159);; 2019北京大学“教学新思路”项目(2019YX007);; 中国中医科学院基本科研业务费专项(ZZ13-YQ-075,Z0650)

作者(Author): 陈瑶;曾雪扬;刘涤非;谭小玉;蔡先明;杨丰文;廖星;孙凤;谢雁鸣;
CHEN Yao;ZENG Xue-yang;LIU Di-fei;TAN Xiao-yu;CAI Xian-ming;YANG Feng-wen;LIAO Xing;SUN Feng;XIE Yan-ming;Institute of Public Health,Peking University;Center for Evidence Based Medical and Clinical Research,Peking University;Centre for Evidence-Based Medicine,Tianjin University of Traditional Chinese Medicine;Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences;

Email:

DOI: 10.19540/j.cnki.cjcmm.20191022.501

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