目的探讨性激素替代疗法(HRT)对类风湿关节炎(RA)的疗效。方法检索国内外公开发表的关于HRT治疗RA的随机对照试验文献,筛选合格文献进行研究,运用异质性检验、Meta分析等方法统计相关数据。结果共有11项研究符合纳入标准。HRT与安慰剂相比能够降低RA患者的红细胞沉降率(ESR)水平,标准均数差(SMD)为-0.22(-0.40,-0.04),P=0.016;升高患者的骨密度水平,加权均数差(WMD)为2.83(0.41,5.26),P=0.022;降低患者的临床评价指标,SMD为-0.19(-0.38,0.00),P=0.048;降低患者的C反应蛋白(CRP)水平,SMD为-0.08(-0.37,0.21),但差异不具有统计学意义(P=0.591)。结论Meta分析结果显示,HRT能够降低RA患者的ESR水平及临床评价指标,并提高患者的骨密度水平,HRT能够减轻RA患者的病情活动并且抑制骨质疏松,可作为RA治疗的新方法或辅助治疗手段。
Objective To explore the efficacy of hormone replacement therapy (HRT) for rheumatoid arthritis (RA). Methods The literature about HRT in the treatment of rheumatoid arthritis were searched. Eleven papers were subjected to a Meta-analysis and a heterogeneity test was conducted to evaluate the efficacy of HRT. Results HRT reduced the level of erythrocyte sedimentation rate (ESR) in RA patients (P=0.016), the SMD was -0.22(-0.40, -0.04); improved bone mineral density (BMD) in RA patients (P=0.022), the WMD was 2.83 (0.41, 5.26); decreased clinical parameters for disease activity evaluations of RA patients (P=0.048), the SMD was -0.19 (-0.38, 0.00); decreased the level of C-reactive protein (CRP) in RA patients, the SMD was -0.08 (-0.37, 0.21 ), but the difference was not statistically significant (P=0.591). Conclusion The findings from this Meta-analysis indicate that HRT can reduce the ESR level, improve clinical indexes and improve BMD level of RA patients. HRT may suppress disease activity and osteoporosis of RA patients, so it may be used as an auxiliary therapy in the treatment of RA.