独活寄生汤（DJD）是一种中药配方。既往研究报道，DJD可改善类风湿性关节炎（RA）患者的临床症状和实验室指标。但现有证据不够有力且存在争议。从中英文数据库检索DJD治疗RA的随机对照试验，从建库至2023年4月16日，采用Stata 17软件进行Meta分析。我们使用亚组分析、荟萃回归和敏感性分析来识别异质性的潜在来源。从年龄、病程、疗程、实验组或对照组采用的干预措施、随机序列生成等6个方面进行亚组分析和荟萃回归。加尔布雷思图用于查找可能存在异质性的研究。当相关研究数量大于或等于10项时，通过Egger检验和漏斗图评估发表偏倚。共纳入42项研究，涉及3635名患者和19个结果指标。 Meta分析显示，与常规缓解病情抗风湿药物（rDMARDs）相比，DJD能够更好地改善RA患者的实验室指标、主要症状和体征以及问卷评分水平。实验室指标包括类风湿因子、T淋巴细胞亚群（包括CD4、CD8、CD4/CD8）、炎症生物标志物（包括红细胞沉降率、C反应蛋白、肿瘤坏死因子-α、白细胞介素6、白细胞介素1β、白细胞介素）。 1）。主要症状体征包括晨僵持续时间、关节压痛次数、关节肿胀次数、双手握力等。调查问卷包括视觉模拟量表、健康评估问卷以及28个关节的疾病活动评分。此外，DJD治疗的不良事件明显低于rDMARDs。然而，一些亚组分析的结果与总体结果不同。此外，发表偏倚评估显示，在 11 项评估结果中，有 4 项存在发表偏倚。DJD 可能是 RA 令人满意的补充和替代疗法。但由于少数亚组分析结果与总体结果存在差异，尚需进一步研究验证。Copyright © 2023 the Author(s).由 Wolters Kluwer Health, Inc. 出版

Duhuo-Jisheng decoction (DJD) is a Chinese herb formula. Previous studies have reported that the clinical symptoms and laboratory indicators of rheumatoid arthritis (RA) patients could be improved by DJD. However, the existing evidence was not robust enough and controversial.Randomized controlled trials of DJD for RA were retrieved from Chinese and English databases from their inception to April 16, 2023. Meta-analysis was performed by Stata 17 software. We used subgroup analysis, meta-regression, and sensitivity analysis to identify potential sources of heterogeneity. The subgroup analysis and meta-regression were conducted from 6 aspects, including age, course of disease, course of treatment, interventions used in the experimental or control group, and random sequence generation. Galbraith plot was used to find studies with possible heterogeneity. Publication bias was assessed by Egger's test and funnel plots when the number of relevant studies was greater than or equal to 10.Forty-two studies were included, involving 3635 patients and 19 outcome indicators. Meta-analysis showed that, compared with the routine disease-modifying antirheumatic drugs (rDMARDs), DJD could better improve the level of laboratory indicators, main symptoms and signs, and questionnaire scores of RA patients. The laboratory indicators included rheumatoid factor, T lymphocyte subpopulation (including CD4+, CD8+, and CD4+/CD8+), and inflammatory biomarkers (including erythrocyte sedimentation rate, C-reactive protein, tumor necrosis factor-α, interleukin 6, interleukin 1β, and interleukin 1). The main symptoms and signs included the duration of morning stiffness, the number of joint tenderness, the number of swollen joints, and the grip strength of both hands. The questionnaire included visual analogue scale, health assessment questionnaire, and disease activity score in 28 joints. In addition, the adverse events of DJD treatment were significantly lower than those of rDMARDs. However, the results of a few subgroup analyses differed from the overall results. Furthermore, the publication bias assessment showed that, out of 11 evaluated results, 4 had publication bias.DJD could be a satisfactory complementary and alternative therapy for RA. However, due to a small number of subgroup analysis results being different from the overall results, it should be verified by further studies.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.