| Objective:To investigate the pharmacokinetic characteristics of Zhengqing Fengtongning in adjuvant-induced arthritis?AIA?model rats.Systematically to evaluate the efficacy and safety of Zhengqing Fengtongning monotherapy and its combination in the treatment of rheumatoid arthritis?RA?.Methods:To establish the AIA model rats,and the pharmacokinetics of Zhengqing Fengtongning in model rats were studied.Literatures database of CNKI,VIP,Wanfang,and Pubmed,Geenmedical were included and searched comprehensively for related clinical trials published until June 20,2020.The quality of all literatures retrieved manually from these databases was evaluated by the Cochrane Evaluation Handbook 5.1.0,and qualified literatures were reviewed and analyzed by using the Review Manger 5.3Statistical Software.Results:In AIA model SD rats,the Tmaxax was12±4.47min,the Cmaxax was 21.45±7.63?g/mL,the T1/2/2 was 67.40±12.07min,and the AUC0-t-t was 1924.63±229.79?g·min·mL-1,AUC0-?was2081.37±326.14?g·min·mL-1,CL/F was 47.27±5.27mL·min-1·kg-1,the V/F was 4341.70±687.52mL/kg.Finally,a total of 36 literatures and 3767 patients were included.The results showed that the total clinical efficiency,the improvement of grip strength,the improvement of joint swelling index,the improvement of joint tenderness index,the improvement of blood sedimentation,the improvement of rheumatoid factor and the improvement of C-reactive protein?CRP?in the Zhengqing Fengtangning monotherapy subgroup were similar to those in the control group.The improvement of morning stiffness time was significantly superior to those treated in the control group.The total clinical efficiency,the improvement of morning stiffness time,the improvement of grip strength,the improvement of joint swelling index,the improvement of joint tenderness index,the improvement of blood sedimentation,the improvement of rheumatoid factor and the improvement of c-reactive protein in Zhengqing Fengtouning combined with conventional western medicine subgroup were all significantly superior to those treated in the control group.The safety of Zhengqing Fengtongning monotherapy subgroup and its combination subgroup was significantly superior to the control group.Conclusion:Compared with normal SD rats,the absorbtion and elimination of Zhengqing Fengtongning at a faster rate in the pathological state of RA in SD rats,but may be with a lower absorbtion level.In other words,RA changed the pharmacokinetic behavior of Zhengqing Fengtongning in SD rats.Based on the current evidence,the therapeutic effect of Zhengqing Fengtongning monotherapy for RA is comparable to that of basic drugs for RA.The treatment of Zhengqing Fengtongning in combination with RA basic drug can significantly improve the total clinical efficiency,improve the clinical symptoms and reduce the laboratory index.The safety of Zhengqing Fengtongning monotherapy group and its combination medication group was better than that of the control group.However,due to the limitation of the quantity and quality of the included studies,high-quality randomized controlled clinical trials are still needed to be carried out to further systematically evaluate the efficacy and safety of Zhengqing Fengtongning monotherapy and its combination with conventional western medicine in the treatment of RA. |
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