| Objective:In this study,a meta-analysis was used to comprehensively and scientifically eval uate the efficacy of TCM external treatment for ankylosing spondylitis and provide evi dence-based medical evidence for the clinical application of TCM.Method:Through a comprehensive search of the Chinese and English databases from the e stablishment of the database to January 2020,a randomized controlled literature on the treatment of ankylosing spondylitis(acupuncture,moxibustion,traditional Chinese med icine fumigation,traditional Chinese medicine application)from the external treatment of Chinese medicine,based on Literature selection and exclusion criteria,complete dat a extraction,perform Meta analysis through Revman 5.3 software and evaluate the qua lity of the literature and the clinical efficacy of external treatment of traditional Chine se medicine(acupuncture,moxibustion,traditional Chinese medicine fumigation,traditio nal Chinese medicine application),Effectiveness of symptoms and signs,laboratory ind icators,etc.Result:Part ?: Acupuncture combined with conventional drugs for ankylosing spondylitis:a systematic review and meta-analysisA total of 2219 articles were retrieved in this study.After screening,it was d etermined that 9 articles were finally included,with a total of 655 patients.1.Meta analysis results for total efficiency show:[OR=4.08,95%CI(2.11,7.91),P?0.0001]The difference between the two groups was statistically significant.2.The overall evaluation results of Meta analysis show:Pain visual simulation scor e(VAS score)[MD=-1.85,95%CI(-2.37,-1.33),P?0.00001];Bath ankylosing spondyli tis activity index(BASDAI)[SMD=-0.93,95%CI(-1.21,-0.66),P?0.00001];Bath an kylosing spondylitis function indexBath(BASFI)[SMD=-0.68,95%CI(-1.01,-0.34),P?0.0001].The above results suggest that the difference is statistically significant.3.The results of the meta-analysis of the function of the central axis of the spineshow that:Thoracic activity[MD=0.68,95%CI(0.50,0.86),P?0.00001];Finger distanc e[MD=-2.43,95%CI(-3.22,-1.65),P?0.00001];Hip distance[MD=-2.21,95%CI(-3.48,-0.94),P=0.0007];Schober test[MD=0.72,95%CI(0.57,0.87),P?0.00001]The abo ve results suggest that the difference between the two groups is statistically significant.Pillow distance[MD=-0.41,95%CI(-0.70,-0.11),P=0.007]The difference between the two groups is statistically significant,short-term treatment[MD=-0.24,95%CI(-0.63,0.15),P=0.23]The difference between the two groups was not statistically significant.Long-te rm treatment [MD=-0.63,95%CI(-1.09,-0.18),P=0.06] The difference between the two g roups was statistically significant.Spinal activity [MD=-0.01,95%CI(-0.29,0.27),P=0.96]T here was no significant difference between the two groups.4.The meta-analysis results of inflammation indicators show:ESR[MD=-6.75,95%C I(-8.4,-5.46),P?0.00001],CRP[MD=-4.83,95%CI(-6.07,-3.58),P?0.00001]The a bove results suggest that the differences between the two groups are statistically signif icant.Part ?: Moxibustion combined with conventional drugs for ankylosing spondylitis:a systematic review and meta-analysisA total of 1962 articles were retrieved in this study,and after screening,17 articl es were finally included,with a total of 1045 patients.1.The meta-analysis results of total efficiency showed:[OR=3.76,95% CI(2.34,6.05),P?0.00001]The difference between the two groups was statistically significant.2.Meta-analysis results of overall evaluation show: visual analogue score of pain(VAS score)[MD=-1.20,95%CI(-1.86,-0.55),P=0.0003]The difference between the t wo groups is statistically significant,short-term treatment[MD=-1.63,95%CI(-2.44,-0.83),P?0.0001]The difference between the two groups is statistically significant,long-term treatment[MD=-0.71,95%CI(-2.15,0.73),P=0.33]No statistically significant difference be tween the two groups;Bath ankylosing spondylitis activity index(BASDAI)[SMD=-0.93,95%CI(-1.21,-0.66),P?0.00001]The difference between the two groups is statisti cally significant,short-term treatment[MD=-0.90,95%CI(-1.62,-0.19),P=0.01]The differ ence between the two groups is statistically significant,long-term treatment[MD=0.16,95%CI(-2.33,2.64),P=0.90]No statistically significant difference between the two group s;Bath ankylosing spondylitis function index(BASFI)[SMD=-2.07,95%CI(-3.78,-0.36),P=0.02]The difference between the two groups is statistically significant;Bath a nkylosing spondylitis measurement index(BASMI)[MD=-0.40,95%CI(-2.21,1.41),P=0.67]No statistically significant difference between the two groups;duration of morni ng stiffness[MD=-3.18,95%CI(-6.93,0.56),P=0.10]The difference between the two g roups was not statistically significant.3.The results of the meta-analysis of the function of the central axis of the spine show that:Thoracic activity[SMD=0.22,95%CI(0.06,0.38),P=0.006]The difference i s statistically significant,the significance of short-term treatment[MD=0.74,95%CI(-1.47,2.96),P=0.51]No statistically significant difference,long-term treatment[MD=0.20,95%CI(0.01,0.40),P=0.02]The difference between the two groups is statistically significant;Pillow distance[MD=-0.93,95%CI(-1.40,-0.45),P=0.0001]The difference between the two groups is statistically significant,short-term treatment[MD=-1.05,95%CI(-2.62,0.51),P=0.19]No statistically significant difference between the two groups,long-term trea tment[MD=-0.90,95%CI(-1.55,-0.25),P=0.006]The difference between the two groups i s statistically significant;refers to the ground distance[SMD=-0.70,95%CI(-0.88,-0.53),P?0.00001],Spinal mobility[MD=0.59,95%CI(0.19,0.99),P=0.004]The above resul ts suggest that the differences between the two groups are statistically significant.Hip distance[SMD=-0.34,95%CI(-0.74,-0.06),P=0.09]The difference between the two gr oups was not statistically significant.4.The meta-analysis results of inflammation indicators show:ESR[MD=-5.56,95%C I(-9.78,-1.52),P=0.007]The difference between the two groups is statistically signifi cant,short-term treatment[MD=-9.63,95%CI(-17.12,-2.14),P=0.01]The difference betwe en the two groups is statistically significant,long-term treatment[MD=-3.46,95%CI(-7.96,1.03),P=0.13]The difference between the two groups was not statistically significant;CRP[MD=-4.90,95%CI(-8.53,-1.27),P=0.008]The difference between the two group s is statistically significant,short-term treatment[MD=-7.17,95%CI(-12.34,-4.00),P=0.0001]The difference between the two groups is statistically significant,long-term treatment[MD=-2.47,95%CI(-5.93,0.99),P=0.16]The difference between the two groups was not statistically significant.Part ?: Chinese Medicine Fumigation Combined with Conventional Medicine fo r Ankylosing Spondylitis;a systematic review and meta-analysisA total of 660 literatures were searched in this study.After screening,it was dete rmined that 11 literatures were finally included,with a total of 617 patients.1.Meta analysis results for total efficiency show:[OR=4.24,95%CI(2.17,8.27),P?0.0001]The difference between the two groups was statistically significant.2.The overall evaluation results of Meta analysis show:Pain visual simulation scor e(VAS score)[MD=-1.51,95%CI(-2.44,-0.57),P=0.003],Bath Ankylosing Spondylitis Activity Index(BASDAI)[MD=-0.44,95%CI(-0.62,-0.26),P?0.00001],Bath Ankylos ing Spondylitis Function Index(BASFI)[MD=-0.91,95%CI(-1.29,-0.54),P?0.00001],Morning stiffness duration[SMD=-0.71,95%CI(-0.97,-0.45),P?0.00001]The above r esults suggest that the difference between the two groups is not statistically significant.3.The results of the meta-analysis of the function of the central axis of the spine show that:Pillow distance[MD=-0.47,95%CI(-0.84,-0.11),P=0.01]Schober test[MD=1.20,95%CI(0.29,2.11),P=0.010]The above results suggest that the difference betwee n the two groups is statistically significant;Finger distance[MD=-0.40,95%CI(-1.11,-0.31),P=0.27],Thoracic activity[MD=1.48,95%CI(-0.48,3.44),P=0.14]The above res ults suggest that the difference is not statistically significant.4.The meta-analysis results of inflammation indicators show:ESR[MD=-7.36,95%C I(-9.07,-5.65),P?0.00001],CRP[SMD=-0.55,95%CI(-0.77,-0.34),P?0.00001]The above results suggest that the difference between the two groups is statistically signif icant;TNF?[MD=3.45,95%CI(-6.10,13.00),P=0.48]The difference between the two g roups was not statistically significant.Part ?: Traditional Chinese Medicine Application Combined with Conventional Medicine for Ankylosing Spondylitis: a systematic review and meta-analysisA total of 196 articles were retrieved in this study.After screening,10 articles w ere finally included,with a total of 1041 patients.1.Meta analysis results for total efficiency show:[OR=3.31,95%CI(2.20,4.98),P?0.00001]The difference between the two groups was statistically significant.2.The overall evaluation results of Meta analysis show:Pain visual simulation scor e(VAS score)[MD=-1.78,95%CI(-2.58,-0.98),P?0.0001],Bath Ankylosing Spondyli tis Activity Index(BASDAI)[MD=-1.41,95%CI(-1.86,-0.97),P?0.00001],Bath Anky losing Spondylitis Function Index(BASFI)[MD=-1.25,95%CI(-1.54,-0.96),P?0.00001],Morning stiffness duration[MD=-8.08,95%CI(-10.38,-5.79),P?0.00001]The abo ve results suggest that the differences between the two groups are statistically significa nt.3.The results of the meta-analysis of the function of the central axis of the spine show that:Thoracic activity[[SMD=0.56,95%CI(0.39,0.73),P?0.00001]?Pillow d istance[MD=-0.42,95%CI(-0.81,-0.03),P=0.03],Finger distance[SMD=-0.53,95%CI(-0.71,-0.36),P?0.00001]The above results suggest that the difference between the t wo groups is statistically significant;Spinal mobility[MD=2.51,95%CI(-2.04,7.05),P=0.28]The difference between the two groups was not statistically significant.4.The meta-analysis results of inflammation indicators show:ESR[SMD=-0.43,95%CI(-0.58,-0.28),P?0.00001],CRP[SMD=-0.41,95%CI(-0.66,-0.16),P=0.001]The a bove results suggest that the difference between the two groups is statistically significa nt.Conclusion:Part ?: Acupuncture combined with conventional drugs for ankylosing spondylitis:a systematic review and meta-analysis1.The clinical effect of acupuncture combined with conventional drugs in the treatme nt of ankylosing spondylitis is definite.2.Acupuncture combined with conventional drug therapy improves the BASDAI,BAS FI,VAS scores of patients with ankylosing spondylitis,and has a better effect than th e simple use of conventional drugs.3.Acupuncture combined with conventional drug treatment is superior to simple conve ntional drug treatment in improving the function of the central axis of the spine(thoracic activity,occipital wall distance,finger-to-ground distance,heel-to-hip distance,Sch ober test)in patients with ankylosing spondylitis.Less than or equal to 1 month)treat ment has no significant difference between the two interventions in improving the pill ow wall distance.There is no significant difference between the improvement of spina l mobility and conventional medication.4.The improvement of ESR and CRP in patients with ankylosing spondylitis by acup uncture combined with conventional medication is better than conventional medication.Part ?: Moxibustion combined with conventional drugs for ankylosing spondylitis:a systematic review and meta-analysis1.The clinical effect of moxibustion combined with conventional drugs in the treatme nt of ankylosing spondylitis is definite.2.Moxibustion combined with conventional drug treatment improves the BASDAI,BA SFI,VAS scores of patients with ankylosing spondylitis,and has a better effect than t he simple use of conventional drugs.However,there was no significant difference bet ween the improvement of BASMI and the duration of morning stiffness compared wit h the use of conventional drugs alone.3.Moxibustion combined with conventional drugs is superior to the simple use of con ventional drugs in the improvement of spinal central axis function(thoracic activity,o ccipital distance,finger distance,spine activity)in patients with ankylosing spondylitis.However,there is no obvious difference between the improvement of hip distance an d conventional drug treatment.In terms of treatment course,the effect of short-term tr eatment on thoracic activity and occipital wall distance is better than that of conventio nal medicine alone,but there is no significant difference between the two interventions after long-term treatment.4.The short-term treatment of moxibustion combined with conventional drugs is superi or to conventional drugs in improving the ESR and CRP in patients with ankylosing s pondylitis.In terms of treatment course,the short-term treatment of moxibustion combi ned with conventional drugs improves the ESR and CRP better than the conventional drugs alone,while the long-term treatment has no significant difference between the two interventions.Part ?: Chinese Medicine Fumigation Combined with Conventional Medicine fo r Ankylosing Spondylitis;a systematic review and meta-analysis1.The clinical efficacy of Chinese medicine fumigation combined with conventional dr ugs in the treatment of ankylosing spondylitis is definite.2.Traditional Chinese medicine fumigation combined with conventional drug treatment improves BASDAI,BASFI,duration of morning stiffness,and VAS score of patients with ankylosing spondylitis,which has better efficacy than conventional drugs.3.Traditional Chinese medicine fumigation combined with conventional medicines is b etter than simple conventional medicines in improving the function of the central axis of the spine in patients with ankylosing spondylitis.However,there is no significant d ifference in improvement of finger distance and thoracic activity compared with conve ntional drug therapy.4.Chinese medicine fumigation combined with conventional drug treatment is better th an conventional drug treatment in improving the ESR and CRP in patients with ankyl osing spondylitis.There was no significant difference in the effect of TNF-?.Part ?: Traditional Chinese Medicine Application Combined with Conventional Medicine for Ankylosing Spondylitis: a systematic review and meta-analysis1.The clinical efficacy of traditional Chinese medicine application combined with con ventional drugs in the treatment of ankylosing spondylitis is definite.2.The application of traditional Chinese medicine combined with conventional medicat ions can improve the BASDAI,BASFI,duration of morning stiffness,and VAS scores of patients with ankylosing spondylitis.3.Traditional Chinese medicine application combined with conventional medicine is be tter than traditional medicine treatment in improving the function of central axis of th e spine(finger distance,occipital wall distance,thoracic activity,Schober test)in anky losing spondylitis.However,there is no significant difference between the improveme nt of spinal mobility and conventional drug treatment.4.The improvement of ESR and CRP in patients with ankylosing spondylitis with traditional Chinese medicine application combined with conventional medicine treatment i s better than conventional medicine treatment. |
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