背景:桥本甲状腺炎(HT)的常规治疗方法有限。草药(HM)被认为是治疗HT的潜在干预措施。
目的:本研究旨在探讨HM治疗HT的有效性和安全性。
方法:在PubMed,科克伦图书馆,WebofScience,EMBASE,中国临床试验注册中心(ChiCTR),中国国家知识基础设施(CNKI),中国科技期刊数据库(VIP),中国生物医学数据库(CBM),和万方数据库从成立到2022年10月1日进行了搜索。结果包括主要结果(TPOAb),次要结果(TSH,TGAb,FT3,FT4和中医症状评分),和不良事件。本研究在PROSPERO(CRD420223640)注册。
结果:回顾了16项试验,并比较了16个HM公式。与非药物治疗(NDT)相比,所有的疗法,除了调气清解疗法,降低了TPOAb的主要结果,具有不同的有效性水平,范围从0.01(95CI0.00,0.02)到0.92(95CI0.56,1.53)。排名概率分析表明,益气化瘀方,理气消英汤,而舒肝散结疗法降低甲状腺抗体水平最多,包括TPOAb(100.0%,90.9%,90.3%,分别)和TGAb(98.3%,94.4%,和87.3%,分别)。所有HMs均对中医症状评分显着影响,并可能使HT的治疗受益。范围从6.62(95%CI2.06,21.24)到94.50(95%CI15.97,559.14)。未报告严重不良事件。
结论:中草药治疗HT可能有效,特别是在降低甲状腺抗体水平和改善临床症状而不影响甲状腺功能方面。然而,这些结果应被视为初步结果,并使用高质量证据进一步验证.
BACKGROUND: Conventional treatments for Hashimoto\'s
thyroiditis (HT) are limited. Herbal medicines (HM) are considered a potential intervention for the treatment of HT.
OBJECTIVE: This study aimed to investigate the efficacy and safety of HM for HT.
METHODS: A Bayesian network meta-analysis was conducted for patients with HT in randomized controlled trials identified in PubMed, Cochrane Library, Web of Science, EMBASE, Chinese Clinical Trial Registry (Chi CTR), China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (the VIP), China Chinese Biomedical Database (CBM), and Wanfang Database were searched from their inception to Oct 1, 2022. Outcomes included the primary outcome (TPOAb), secondary outcomes (TSH, TGAb, FT3, FT4, and traditional Chinese medicine symptom scores), and adverse events. This study was registered in PROSPERO (CRD42022363640).
RESULTS: Sixteen trials were reviewed and 16 HM formulae were compared. Compared with non-drug therapy (NDT), all therapies, except for Tiaoqi-Qingjie Therapy, reduced the primary outcome of TPOAb with different levels of effectiveness, ranging from 0.01 (95%CI 0.00, 0.02) to 0.92 (95%CI 0.56, 1.53). Ranking probability analysis indicated that Yiqi Huayu Recipe, Liqi Xiaoying decoction, and Shugan Sanjie therapy reduced thyroid antibody levels the most, including TPOAb (100.0%, 90.9%, and 90.3%, respectively) and TGAb (98.3%, 94.4%, and 87.3%, respectively). All HMs displayed a significant effect on the TCM Symptom score and possibly benefitted the treatment of HT, ranging from 6.62 (95% CI 2.06, 21.24) to 94.50 (95% CI 15.97, 559.14). No serious adverse events were reported.
CONCLUSIONS: Herbal medicines may be effective in the treatment of HT, especially in reducing thyroid antibody levels and improving clinical symptoms without affecting thyroid function. However, these results should be considered preliminary and further verified using high-quality evidence.