Treatment of ankylosing spondylitis with Zhengqing Fengtongning release tablets: Meta-analysis of randomized controlled trials

Abstract

The review aims to assess the effectiveness and safety of Zhengqing Fengtongning release tablets in treating ankylosing spondylitis (AS) systematically through searching relevant electronic databases and collecting relevant literature. Such Chinese databases as CNKI, VIP, Wanfang, and English databases as PubMed, EMbase and Cochrane Library, etc, were searched from the date of their establishment to September 2017. According to the inclusion and exclusion criteria, the methodology quality of included studies was evaluated by two independent reviewer using Cochrance evaluation system, and Meta-analysis on the clinical efficacy and safety of Zhengqing Fengtongning release tablets for AS was conducted with RevMan 5.3 software. Seven randomized control trials (RCTs) including 570 patients of AS were included, with 294 patients in Zhengqing Fengtongning treatment group and 276 patients in the western medicine control group. Meta-analysis showed that: Zhengqing Fengtongning alone treatment was superior to sulfasalazine groups in the effect on improving the total effective rate. Besides, as compared to sulfasalazine control group, the time of morning stiffness and the finger-to-floor distance were significantly shortened in Zhengqing Fengtongning treatment group. However, the cciput-to-wall distance， the chest expansion, Schober's test, disease activity score (DAS) in patients, disease activity score (DAS) in doctors, ESR, CRP showed no statistically significant differences. As compared with western medicine control group, Zhengqing Fengtongning combined with western medicine had a higher total effective, significantly shorten the time of morning stiffness, and increase Schober's test values; However, the cciput-to-wall distance, the finger-to-floor distance, the chest expansion, DAS in patients, DAS in doctors, ESR and CRP showed no statistically significant differences. Zhengqing Fengtongning had less adverse reactions in clinical application, and the main adverse reaction was skin rash or itching when used alone. The study showed: Zhengqing Fengtongning is effective for AS with high safety, but high quality clinical trials are still needed to further prove its clinical efficacy and safety.