蜡疗结合常规药物治疗类风湿关节炎临床效果的meta分析

doi:10.5246/jcps.2025.03.022

中国药学(英文版) ›› 2025, Vol. 34 ›› Issue (3): 284-292.DOI: 10.5246/jcps.2025.03.022

• 【药事管理与临床药学专栏】 • 上一篇

蜡疗结合常规药物治疗类风湿关节炎临床效果的meta分析

曾王星¹^,^#, 邓茜¹^,^#, 彭紫凝¹^,^#, 孟凡雨¹, 晏蔚田²^,^*(), 刘念¹^,^*(), 彭江云²^,^*()

^1. 云南中医药大学第一临床医学院, 云南昆明 650500
^2. 云南中医药大学第一附属医院风湿病科, 云南昆明 650021

收稿日期:2024-07-13 修回日期:2024-09-26 接受日期:2024-11-24 出版日期:2025-03-31 发布日期:2025-04-01
通讯作者: 晏蔚田, 刘念, 彭江云

Meta-analysis of the clinical efficacy of wax therapy combined with conventional pharmacotherapy in rheumatoid arthritis treatment

Wangxing Zeng¹^,^#, Qian Deng¹^,^#, Zining Peng¹^,^#, Fanyu Meng¹, Weitian Yan²^,^*(), Nian Liu¹^,^*(), Jiangyun Peng²^,^*()

¹ First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming 650500, Yunnan, China
² Department of Rheumatology, The No.1 Affiliated Hospital of Yunnan University of Chinese Medicine, Kunming 650021, Yunnan, China

Received:2024-07-13 Revised:2024-09-26 Accepted:2024-11-24 Online:2025-03-31 Published:2025-04-01
Contact: Weitian Yan, Nian Liu, Jiangyun Peng
About author:
^# Wangxing Zeng, Qian Deng and Zining Peng contributed equally to this work.
Supported by:
The Key Research and Development Program of Yunnan Science and Technology Department (Grant No. 202303AC100326), the National Natural Science Foundation of China (Grant No. 81960863) and the Education Department of Yunnan Province (Grant No. 2023Y0463 and 2024Y380).

摘要/Abstract

摘要：

本研究系统评价蜡疗结合常规药物治疗类风湿关节炎(rheumatoid arthritis, RA) 的临床效果, 为蜡疗在类风湿关节炎的治疗中提供临床依据。通过在PubMed、Cochrane Library、中国生物医学文献数据库(CBM)、中国期刊全文数据库(CNKI)、万方和VIP数据库等, 从建库至2024年5月进行检索。纳入蜡疗结合传统药物治疗RA的临床随机对照试验。统计学分析采用Review Manager5.3软件进行Meta分析。本研究共纳入9项研究, 共843例患者。联合治疗组相比单独使用常规药物治疗组显示出更高的临床疗效率[RR = 1.22, 95% Cl (1.11, 1.34)]。此外, 联合治疗组在改善DAS28评分[MD = –0.90, 95% CI (–1.23, –0.57), P < 0.00001]、改善VAS评分[MD = –0.90, 95% CI (–1.13, –0.66), P < 0.00001]、减少关节压痛计数[MD = –1.27, 95% CI (–1.81, –0.72), P < 0.00001]、缩短晨僵持续时间[MD = –25.47, 95% CI (–34.33, –16.61), P < 0.0001]以及降低C反应蛋白[MD = –6.29, 95% CI (–12.02, –0.57), P < 0.05]等方面均显示出优势。研究表明, 蜡疗结合常规口服抗风湿药物治疗可以有效提高RA的临床疗效, 在缓解患者病情、改善关节疼痛、晨僵的症状及降低C反应蛋白等方面其效应均优于单独使用常规药物治疗。

关键词: 类风湿关节炎, 蜡疗, 临床效果, meta分析

Abstract:

This study aimed to systematically evaluate the clinical efficacy of combining wax therapy with conventional drug therapy for rheumatoid arthritis (RA) and to provide evidence supporting its clinical application. A comprehensive search was conducted across PubMed, Cochrane Library, China Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Wanfang, and VIP databases from their inception to May 2024. Randomized controlled trials (RCTs) investigating the combination of wax therapy and conventional drug therapy for RA were included in the analysis. Statistical analysis was performed using Review Manager 5.3 software. Nine studies, encompassing a total of 843 patients, were included. The results demonstrated that the combination therapy significantly improved clinical efficacy compared to conventional drug therapy alone [RR = 1.22, 95% CI (1.11, 1.34)]. Moreover, the combination therapy led to notable improvements in DAS 28 scores [MD = –0.90, 95% CI (–1.23, –0.57), P < 0.00001], VAS scores [MD = –0.90, 95% CI (–1.13, –0.66), P < 0.00001], reduction in joint tenderness [MD = –1.27, 95% CI (–1.81, –0.72), P < 0.00001], decreased duration of morning stiffness [MD = –25.47, 95% CI (–34.33, –16.61), P < 0.00001], and lowered C-reactive protein levels [MD = –6.29, 95% CI (–12.02, –0.57), P < 0.05]. In conclusion, wax therapy combined with conventional anti-rheumatic drugs significantly enhanced the clinical outcomes for RA patients by alleviating symptoms, reducing joint pain and morning stiffness, and decreasing inflammatory markers more effectively than conventional drug therapy alone.

Key words: Rheumatoid arthritis, Wax therapy, Clinical effects, Meta-analysis

Supporting:

曾王星, 邓茜, 彭紫凝, 孟凡雨, 晏蔚田, 刘念, 彭江云. 蜡疗结合常规药物治疗类风湿关节炎临床效果的meta分析[J]. 中国药学(英文版), 2025, 34(3): 284-292.

Wangxing Zeng, Qian Deng, Zining Peng, Fanyu Meng, Weitian Yan, Nian Liu, Jiangyun Peng. Meta-analysis of the clinical efficacy of wax therapy combined with conventional pharmacotherapy in rheumatoid arthritis treatment[J]. Journal of Chinese Pharmaceutical Sciences, 2025, 34(3): 284-292.

图/表 9

Table 1. Presents the fundamental characteristics of the literature included in the study.

Figure 1. Flowchart of literature search results.

Figure 2. Bias risk in the included studies.

Figure 3. Forest plot of total response rate between wax therapy + conventional anti-RA treatment vs. conventional anti-RA treatment.

Figure 4. Forest plot comparing DAS28 scores for wax therapy + conventional anti-RA treatment vs. conventional anti-RA treatment.

Figure 5. Forest plot comparing the VAS scores of wax therapy + conventional anti-RA treatment vs. conventional anti-RA treatment.

Figure 6. Forest plot of joint tenderness count between wax therapy + conventional anti-RA treatment vs. conventional anti-RA treatment.

Figure 7. Forest plot comparing the duration of morning stiffness in patients receiving wax therapy + conventional anti-RA treatment vs. conventional anti-RA treatment only.

Figure 8. Forest plot comparing wax therapy + conventional anti-RA treatment vs. conventional anti-RA treatment for CRP.

参考文献 21

[1]	Di Matteo, A.; Bathon, J.M.; Emery, P. Rheumatoid arthritis. Lancet. 2023, 402, 2019–2033.
[2]	Scublinsky, D.; Gonzalez, C.D. Quantifying disease in challenging conditions: incidence and prevalence of rheumatoid arthritis. J. Rheumatol. 2016, 43, 1263–1264.
[3]	Molteni, E.; Adinolfi, A.; Bondi, V.; Delvino, P.; Sakellariou, G.; Trentanni, C.; Ughi, N.; Pozzi, M.R.; Scirè, C.A. Novel insights into the management of rheumatoid arthritis: one year in review 2024. Clin. Exp. Rheumatol. 2024, 42, 947–960.
[4]	Brown, P.; Pratt, A.G.; Hyrich, K.L. Therapeutic advances in rheumatoid arthritis. BMJ. 2024, 384, e070856.
[5]	Wang, Y.Z.; Yang, C.; Zhu, C.P.; Zhao, Q.Q.; Lu, X.H.; Su, X.Y.; Wang, Y.H. Upper limb arthromyodynia can be treated with Notopterygium by down-regulating P2X3 to mediate PKC-induced inflammatory response. J. Chin. Pharm. Sci. 2022, 31, 163–175.
[6]	Chen, M.X.; Jiang, Y.T.; Zhang, L.; Chen, Y.L.; Xu, L.; Wang, D.; Li, R.; Ding, J.; Su, Y.S.; Zhang, L.P. Clinical observation on the treatment of joint swelling and pain of RA windcold-dampness arthralgia syndrome by Dai medicine with Longmeng Shahou medicinal powder. Liaoning J. TCM. 2024, 1–14.
[7]	Liu, P.J.; Li, W.Y.; Zheng, X.X.; Qin, N.; Du, Z.Q.; Zhang, Y.S. Rheumatoid arthritis of damp-heat obstruction syndrome treated by external application of Pingle Jingu Tongxiao Plaster combined with oral western medicine in 72 cases. J. TCM. 2021, 62, 57–60.
[8]	Lei, L.; Cheng, Y.Q.; Qian, C. Effect of Lianhua Qingwen granule combined with cefotaxime sodium on the efficacy and serum inflammatory factors in children with pediatric pneumonia. J. Chin. Pharm. Sci. 2023, 32, 947–953.
[9]	Chinese Medical Association Rheumatology Branch. 2018 Guidelines for the Diagnosis and Treatment of Rheumatoid Arthritis in China. Chin. J. Inter. Med. 2018, 57, 242–243.
[10]	Li, C.; Wang, S.; Xu, S.B.; Liu, G.F. Clinical effect of Chinese herbal wax therapy combined with low molecular weight heparin calcium on patients with superficial venous thrombosis of lower limbs. Chin. Traditional Patent Med. 2019, 45, 3858–3861.
[11]	Xiao, W.X.; Hao, N.; Li, H.M.; Zhang, M.M. Clinical effect of wet compress with self-designed Sanggui Shuangzhi Decoction combined with Wax Therapy in treating patients with shoulder pain after stroke with syndrome of yang deficiency and cold coagulation. World Comb. Trad. Chin. West Med. 2023, 17, 1444–1447, 1452.
[12]	Lei, J.; Tan T.; Zhou, L.; Chen, C. Effect of Tongbi Zhitong Powder wax therapy combined with traditional Chinese medicine on acute joint pain and swelling for patients with active rheumatoid arthritis. J. Sichuan TCM. 2022, 40, 124–128.
[13]	Li, N.; Yuan, Q.; Zhang, J. Clinical effect of Mahuang Fuzi Xixin Decoction wax therapy on rheumatoid arthritis of cold dampness obstruction type. Liaoning J. TCM. 2022, 49, 90–93.
[14]	Wang, J.; Wen, R. Clinical efficacy of Chinese Medicine Paraffin in Treatment of Rheumatoid Arthritis Patients with Wind-Cold and Dampness Syndromes and The Change and Significance of Serum MMP-3, OPG and RANKL. Chin. Arch. Tradit. Chin. Med. 2018, 36, 1868–1871.
[15]	Huang, X.Y.; Zheng, H.F.; Song, X.W.; Xu, L.P.; Wu, T. Observation on the Treatment of Rheumatoid Arthritis with Traditional Chinese Medicine Wax Therapy Combined with Western Medicine: A Case Series of 31 Cases. J. Zhejiang TCM. 2018, 53, 289–290.
[16]	Li, F.Y.; Liu, T. The clinical effects of herbal wax therapy on rheumatoid arthritis. Rheum. Dis. Arthrit. 2017, 6, 25–27.
[17]	Ni, J.J.; Jin, F.M. Wax therapy combined with nursing intervention in treating 35 patients with rheumtoid arthritis. West J. TCM. 2016, 29, 124–126.
[18]	Wei, N.; Xue, Z.F.; Chen, Z.J.; Zhu, Y.L. Clinical Study on the Treatment of Knee Lesions in Rheumatoid Arthritis with Wax Therapy: A Report of 38 Cases. Jiangsu J. TCM. 2015, 47, 35–37.
[19]	Dai, X.J.; Hu, G.Q.; Zheng, H.X. Clinical Observation on the Therapeutic Effect of Traditional Chinese Medicine Hot Wax Therapy for Rheumatoid Arthritis. Zhejiang J. Integ. Med. West Med. 2015, 25, 691–693.
[20]	Liu, X.F.; Ning, X.L.; Chen, G.Q. The clinical of Chinese paraffin paste treatment in patients with active rheumatoid arthritis. Chin. J. Nurs. 2012, 47, 726–728.
[21]	Tong, S.J.; Lin L.; Wang, Q.; Tian, X.P.; Yin, P. Construction of comprehensive prevention and management platform for rheumatoid arthritis. Chin. J. Health Inf. Manag. 2024, 21, 38–44.

蜡疗结合常规药物治疗类风湿关节炎临床效果的meta分析

Meta-analysis of the clinical efficacy of wax therapy combined with conventional pharmacotherapy in rheumatoid arthritis treatment

RichHTML

可视化

摘要/Abstract

引用本文

使用本文

图/表 9

参考文献 21

相关文章 15

编辑推荐

Metrics

本文评价

[1]	宋志红, 杨金姬, 张洪壮, 范文霞, 朱安琪, 李少杰, 付浩. 丹参治疗病理性瘢痕的临床疗效: 系统评价与Meta分析[J]. 中国药学(英文版), 2024, 33(9): 846-856.
[2]	张楠, 刘志敏, 杨宣梅, 李爽, 高艺文, 秦海洸. 千斤拔多糖对类风湿关节炎模型小鼠干预效果研究[J]. 中国药学(英文版), 2024, 33(8): 705-713.
[3]	张绮雯, 杨晶, 杨勇杰, 鲁憬莉, 卢晓静, 刘克锋, 周奇, 康建. 洛替拉纳滴眼液治疗蠕形螨睑缘炎有效性和安全性的Meta分析[J]. 中国药学(英文版), 2024, 33(12): 1118-1128.
[4]	宋张鹏, 周锋, 张杨勇, 张洁, 冯媛. 贝伐单抗联合放疗方案通过调节VEGF/VEGFR2信号传导治疗NSCLC患者的系统评价[J]. 中国药学(英文版), 2024, 33(12): 1137-1145.
[5]	高艺文, 李聚仓, 张楠, 李爽, 王莉莉, 秦海洸. 体内外实验探讨千斤拔多糖对类风湿关节炎模型小鼠免疫调节的作用[J]. 中国药学(英文版), 2024, 33(10): 932-942.
[6]	张格第, 刘庚鑫, 晏子友. 基于meta分析和网络药理学理冲汤(丸)治疗癌症的疗效评价及作用机制研究[J]. 中国药学(英文版), 2023, 32(9): 720-735.
[7]	彭词艳, 陈景, 李斯妮, 李健和, 彭六保. 哌柏西利联用来曲唑对比多西他赛联用表柔比星一线治疗晚期乳腺癌的循证药物经济学评价[J]. 中国药学(英文版), 2023, 32(3): 214-222.
[8]	李雅静, 白雅雯, 杜宇, 严长宏, 麻春杰, 孙丽宁, 卜凤跃, 严昊阳. 玉屏风散治疗慢性肾小球肾炎的临床疗效评价及作用机制研究[J]. 中国药学(英文版), 2023, 32(12): 1006-1026.
[9]	李敏, 常路路, 岳向峰, 杜书章. ACEI联合丹参酮治疗肺心病急性加重期的疗效和安全性的meta分析[J]. 中国药学(英文版), 2022, 31(11): 853-865.
[10]	孙颖光, 岳圆圆, 邵杰敏, 高萌, 邓艳茹, 冯运佳. 康复新液与西瓜霜治疗复发性口腔溃疡疗效比较的meta分析[J]. 中国药学(英文版), 2022, 31(10): 761-772.
[11]	覃思蓓, 贾彤, 扶宇, 李俊蕾, 张欣怡, 祝春素, 梁广楷, 聂小燕, 史录文, 崔一民. CYP3A4基因多态性对心脑血管疾病患者氯吡格雷响应影响的Meta分析[J]. 中国药学(英文版), 2021, 30(9): 762-772.
[12]	周祎, 王军, 张龙. 他汀类药物对于COPD患者肺功能影响的荟萃分析[J]. 中国药学(英文版), 2018, 27(4): 281-288.
[13]	张林, 丁洁卫, 王阳, 金晓宣, 葛伟东, 黄淑婷, 李玉婷. 埃罗妥珠单抗治疗难治性/复发性多发性骨髓瘤临床试验效果的Meta分析[J]. 中国药学(英文版), 2017, 26(7): 528-533.
[14]	肖锐锐, 徐秀琴, 孙磊, 方晓磊, 肖鹏. 降心率药物伊伐布雷定安全性的系统评价[J]. 中国药学(英文版), 2017, 26(5): 379-389.
[15]	张林, 金晓宣, 黄淑婷, 徐雯宇, 丁洁卫. 卡非佐米及其组合药物在治疗多发性骨髓瘤的有效性及安全性分析[J]. 中国药学(英文版), 2017, 26(3): 222-229.