中国药物警戒 ›› 2026, Vol. 23 ›› Issue (4): 450-455.
DOI: 10.19803/j.1672-8629.20250761

• 安全与合理用药 • 上一篇    下一篇

中西药联合治疗成人布鲁氏菌病有效性与安全性Meta分析

梁晓1, 徐霄龙2,3, 白颖璐2, 张学敏2,4, 刘清泉1,2,3,*   

  1. 1内蒙古医科大学中医学院,内蒙古 呼和浩特 010059;
    2首都医科大学附属北京中医医院急诊危重症诊疗中心,北京 100010;
    3北京市中医药研究所急危重症研究室,北京 100010;
    4天津中医药大学中西医结合学院,天津 300193
  • 收稿日期:2025-10-09 出版日期:2026-04-15 发布日期:2026-04-15
  • 通讯作者: *刘清泉,男,主任医师,教授·博导,急危重症与新发突发传染病。E-mail: liuqingquan2003@126.com
  • 作者简介:梁晓,女,在读博士,中蒙医内科学。
  • 基金资助:
    国家中医药管理局高水平中医药重点学科建设项目(zyyzdxk-2023001); 国家自然科学基金资助项目（82474428）; 国家科技重大专项（2025ZD01903000）

Efficacy and Safety of Integrated Traditional Chinese Medicine and Western Medicine in the Treatment of Adult Brucellosis: a Meta-Analysis

LIANG Xiao1, XU Xiaolong2,3, BAI Yinglu2, ZHANG Xuemin2,4, LIU Qingquan1,2,3,*   

  1. 1The Traditional Chinese Medicine College, Inner Mongolia Medical University, Hohhot Inner Mongolia 010059, China;
    2Emergency and Critical Care Center, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Beijing 100010, China;
    3Emergency and Critical Care Research Laboratory, Beijing Institute of Traditional Chinese Medicine, Beijing 100010, China;
    4College of Integrated Traditional and Western Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China
  • Received:2025-10-09 Online:2026-04-15 Published:2026-04-15

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摘要： 目的 分析成人布鲁氏菌病中西药联合治疗的临床有效性和安全性,为临床安全合理用药提供参考。方法 检索中国知网、万方数据、维普网、中国生物医学文献数据库、PubMed、Cochrane Library、Embase数据库,筛选自建库至2025年8月31日关于中西药联合治疗成人布鲁氏菌病的随机对照试验（Randomized Controlled Trial,RCT）,使用CochraneROB 2.0、RevMan 5.4.1进行Meta分析。结果 纳入11篇RCT文献,共1 561例患者。Meta分析结果表明,相较于单纯西药治疗,中西药联合干预的治疗方案可显著提升临床有效率（RR=1.14,95%CI[1.06,1.22],P=0.000 3）,且在不同疗程下（<6周和≥6周）均成立。经中西医结合治疗后,试验组患者血清C反应蛋白（CRP）（SMD= -2.13,95%CI[-2.87,-1.38],P<0.000 01）、白细胞介素6（IL-6）（MD= -7.45,95%CI[-13.81,-1.09],P=0.02）、免疫球蛋白G（IgG）（MD= -3.01,95%CI[-3.33,-2.70],P<0.000 01）、免疫球蛋白M（IgM）（MD= -0.31,95%CI [-0.39,-0.24],P<0.000 01）水平均低于对照组,差异具有统计学意义。安全性分析结果显示,2组不良反应发生率差异无统计学意义（OR=0.66,95%CI[0.39,1.14],P=0.14）。结论 中西药联合治疗可显著提高成人布鲁氏菌病患者的临床有效率,在改善患者炎症状态、调节免疫功能方面具有一定优势。

关键词: 布鲁氏菌病, C反应蛋白（CRP）, 白细胞介素6（IL-6）, 中医药治疗, 系统评价, Meta分析

Abstract: Objective To assess the clinical efficacy and safety of Western medicine combined with Traditional Chinese Medicine (TCM) in the treatment of adult brucellosis. Methods Such databases as CNKI, Wanfang, VIP, SinoMed, PubMed, Cochrane Library, and Embase were searched for randomized controlled trials (RCTs) related to the combined treatment of adult brucellosis with TCM and Western medicine that were published from inception to August 2025. Meta-analysis was conducted using Cochrane ROB 2.0 tool and RevMan 5.4.1 software. Results Eleven RCTs involving 1 561 patients were enrolled. Meta-analysis found that compared with Western medicine alone, the combined therapy significantly improved the clinical effective rate (RR=1.14, 95% CI[1.06, 1.22], P=0.000 3) across different courses of treatment (subgroup analysis: <6 weeks and ≥6 weeks). After combined treatment, serum levels of C-reactive protein (CRP) (SMD= -2.13, 95% CI [-2.87, -1.38], P<0.000 01), interleukin-6 (IL-6) (MD= -7.45, 95% CI [-13.81, -1.09], P=0.02), immunoglobulin G (IgG) (MD= -3.01, 95% CI [-3.33, -2.70], P<0.000 01), and immunoglobulin M (IgM) (MD= -0.31, 95% CI[-0.39, -0.24], P<0.000 01) in the experimental group were significantly lower than in the control group, with statistically significant differences. Safety analysis indicated no statistically significant difference in the incidence of adverse reactions between the two groups (OR=0.66, 95% CI [0.39, 1.14], P=0.14). Conclusion The combination of Western medicine and TCM can significantly enhance the clinical effectiveness in adult patients with brucellosis and shows notable advantages in reducing inflammatory responses and modulating immune function.

Key words: Brucellosis, C-Reactive Protein (CRP), Interleukin-6 (IL-6), Traditional Chinese Medicine Treatment, Systematic Review, Meta-Analysis

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