目的 系統(tǒng)評(píng)價(jià)夏枯草口服液治療甲狀腺功能亢進(jìn)癥的臨床療效與安全性。方法 計(jì)算機(jī)檢索中文學(xué)術(shù)期刊全文數(shù)據(jù)庫(kù)（CNKI）、中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(kù)（CBM）、萬方數(shù)據(jù)庫(kù)（Wanfang Data）、維普中文期刊全文數(shù)據(jù)庫(kù)（VIP）、PubMed、Medline、Embase和Cochrane Library等數(shù)據(jù)庫(kù)，納入夏枯草口服液治療甲狀腺功能亢進(jìn)癥的臨床隨機(jī)對(duì)照試驗(yàn)（RCT），檢索時(shí)限均從建庫(kù)至2021年4月30日，運(yùn)用RevMan 5.3軟件進(jìn)行統(tǒng)計(jì)分析。結(jié)果 共納入8篇RCTs，共計(jì)800例患者。Meta分析結(jié)果顯示：與常規(guī)西藥治療（對(duì)照組）相比，夏枯草口服藥聯(lián)合常規(guī)治療（試驗(yàn)組）在改善臨床有效率方面更為明顯［OR=0.13，95% CI=（0.07，0.18），P<0.001］，并可以有效降低血清游離三碘甲狀腺原氨酸（FT3）［SMD=-0.50，95% CI=（-0.97，-0.03），P=0.04］、血清游離甲狀腺素（FT4）［SMD=-0.46，95% CI=（-0.90，-0.02），P=0.04］和促甲狀腺素受體抗體（TRAb）水平［SMD=-1.59，95% CI=（-2.19，-0.99），P<0.001］，提高血清促甲狀腺激素（TSH）水平［SMD=0.82，95% CI（0.12，1.52），P=0.02］，縮小甲狀腺體積［MD=-0.30，95% CI=（-0.53，-0.06），P=0.01］。安全性評(píng)價(jià)方面，兩組比較差異無統(tǒng)計(jì)學(xué)意義［OR=0.48，95% CI=（0.19，1.22），P=0.12］。結(jié)論 夏枯草口服液可以提高甲狀腺功能亢進(jìn)癥的臨床有效率，能有效降低FT3、FT4及TRAb水平、縮小甲狀腺腫大體積、提高TSH水平。但是受到納入研究數(shù)量和質(zhì)量的限制，上述結(jié)論需要更多的臨床RCTs加以驗(yàn)證。

Objective Systematic evaluation of the clinical efficacy and safety of Prunella vulgaris Oral Liquid in the treatment of hyperthyroidism. Methods A computer search of Chinese academic Journal full-text Database (CNKI), China Biomedical Literature Database (CBM), Wanfang Database (Wanfang Data), VIP Chinese Journal full-text Database (VIP), PubMed, Medline, Embase and CochraneLibrary was conducted to include the clinical randomized controlled trial (RCT) of Prunella vulgaris Oral Liquid in the treatment of hyperthyroidism. The search time limit was from the establishment of the database to April 30, 2021. Statistical analysis was carried out by using RevMan 5.3 software. Results A total of eight randomized controlled trials including 800 subjects were included. Meta-analysis results show that as compared with conventional treatment alone, Prunella vulgaris Oral Liquid combined with conventional treatment is more effective in improving clinical efficiency [OR = 0.13, 95%CI = (0.07, 0.18), P < 0.001], and can effectively reduce serum free triiodo thyroprotinin (FT3) levels [SMD =-0.50, 95%CI = (-0.97,-0.03), P = 0.04], serum free thyroxine (FT4) levels [SMD = -0.46, 95%CI = (-0.90, -0.02), P = 0.04], and thyrotropin receptor antibody (TRAb) levels [SMD =-1.59, 95%CI = (-2.19, -0.99), P < 0.001]; increase serum thyroid stimulating hormone (TSH) levels [SMD = 0.82, 95%CI = (0.12, 1.52), P = 0.02], reduce thyroid volume [MD = -0.30, 95%CI = (-0.53, -0.06), P = 0.01]. 3 studies involved adverse reaction, there was no significant difference between the two groups [OR = 0.48, 95%CI = (0.19, 1.22), P = 0.12]. Conclusion Prunella vulgaris Oral Liquidcan improve the clinical effectiveness of hyperthyroidism, reduce FT3, FT4 and TRAb levels and thyroid volume, and increase the level of TSH. Due to the limitations of quality and quantity of the included studies, this conclusion needs to be verified by high quality research.

R286.7

國(guó)家自然科學(xué)基金青年科學(xué)基金資助項(xiàng)目（81603585，81804070）；國(guó)家中醫(yī)藥管理局重大疑難疾病中西醫(yī)臨床協(xié)作試點(diǎn)項(xiàng)目（2018）