【作者】 谢隽；

【导师】 欧阳恒；

【作者基本信息】 湖南中医药大学 ， 中医外科学， 2007， 硕士

【摘要】 [研究背景]银屑病是皮肤科临床常见的慢性复发性炎症性皮肤病。发病年龄以青壮年为多,易于复发,病程较长,对患者的身体健康和精神影响甚大。中医药治疗银屑病在我国已有千年的历史,近年来,中医在银屑病的治疗上显示了一定优势,很多临床试验都对中医药治疗寻常型银屑病的疗效进行了研究,然而这些试验的质量与疗效并没有得到系统地评价。因此,本系统评价将对中医药治疗寻常型银屑病的临床疗效进行客观的、可信的系统评价。[研究目的]全面了解中医药治疗银屑病的文献现状,对中医药治疗寻常型银屑病的临床疗效进行客观的、可信的系统评价。[研究方法]第一部分：中医药治疗银屑病临床对照文献质量的评价1986年以来至2006年12月底国内所有已完成的、已发表的有关银屑病的临床研究文献。根据文献纳入及排除标准,对所纳入的文献按照临床流行病学／DME方法学的原则和方法所制定的《银屑病中医药治疗性文献系统评价表》进行文献质量评价。从纳入及排除标准、对照的情况、样本含量、组间均衡性及对照药物使用情况、随机情况、盲法的运用情况、统计学方法的运用等方面进行统计分析,计算出各种情况的百分比,并评价其质量。第二部分：中医药治疗银屑病的Meta分析1986年以来至2006年12月底国内所有已完成的、已发表的有关银屑病的临床研究文献。根据文献纳入及排除标准,对所纳入的文献,利用RevMan4.2.8进行Meta分析,不同设计质量的敏感度分析,以及随机效应模型与固定效应模型之间的敏感度分析,绘制漏斗图分析发表性偏倚。【结果及结论】1、文献研究质量分析表明,中医或中西医结合治疗银屑病临床对照研究文献报道中,还存在着不少的问题。主要表现在随机化的问题；盲法的使用问题；分配隐匿的问题；样本量的估算；组问均衡性的问题以及统计学方法等问题。2、Meta分析结果显示,中医或中西医结合治疗银屑病有效,其疗效优于复方青黛丸或胶囊,优于迪银片。经不同质量的敏感度分析以及随机效应模型与固定效应模型之间的敏感度分析,取得了较为一致的结论。更多还原

【Abstract】 [The Background]Psoriasis is a chronic recurrent inflammatory dermatosis. It occurs young people and often recurrent that often requires lifelong treatment and have great effects on body and psyche. Psoriasis may express as a few coin-sized erythematosquamous plaques up to widespread. It has a long history for the Traditional Chinese Medicine (TCM) to treat the psoriasis and accumulates a great deal of clinical experience. Combing traditional Chinese and western medicine can shorten the curative period and alleviate the side effect which has been invoked by the pure western medicine. But we can not evaluate the validity and security systemically of the psoriasis treated by TCM or Combined Traditional Chinese and Western Medicine. So we do it.[objective]To know the literature situation on the psoriasis treated by TCM and Combined Traditional Chinese and Western Medicine, to evaluate the validity and security systemically of the psoriasis treated by TCM or Combined Traditional Chinese and Western Medicine.[Method][The first:The evaluation of literature designate quality the psoriasis treated by TCM.]To collect the clinical reference study literature published from 1986-12.2006. According to the inclusion criteria of literature and include clinical epidemiology/D.M. E’s principle and methods, we designed the unitive systematic review table of the treatment on psoriasis by TCM and Combined Traditional Chinese and Western Medicine to evaluation of Controlled Clinical Trial literature designate quality the psoriasis treated by TCM. On the basis of the inclusion criteria or exclusion criteria, reference situation, sample size, the group balance, the use of the control drugs, random situation, blind method, the method of the statistics, standardization of the control factors, curative judgment index, the analysis of the drop out or lost, the record or analysis of the side the percentage of all effect, the rationality of the conclusion, we compute kinds of situation and do a evaluation.[The second:The Meta Analysis on the psoriasis treated by TCM]To collect the clinical reference study literature published from 1986-12.2006. According to the inclusion criteria of literature, we use the Revman 4.2.8 software, we do the meta analysis, sensibility of the different design sensibility analysis between the random factor and fix factor model, then we draw the funnel plot and analyze the bias on the publication. [results and Conclusion]1. The quality-Analysis result of study of literature indicate that there are respect table problem in the Controlled Clinical Trial literature reports on the psoriasis treated by TCM and Combined Traditional Chinese and Western Medicine. The primary manifest are that random situation、blind method、ample size、the group balance、the method of the statistics。2. Meta_ Analysis result indicate that TCM or Combined Traditional Chinese and Western Medicine do really have the good therapeutic efficacy on the psoriasis, the result is better than qindai pills/capsules, than diyin tablet. Sensibility of the different design sensibility analysis between the random factor and fix factor model, we do the same conclusion.更多还原