目的 系统评价雷公藤制剂联合治疗免疫疾病的疗效及安全性。方法 检索中国学术期刊全文数据库（CNKI）、万方数据库（Wanfang Data）、维普生物医学数据库（VIP）、Pubmed、Web of Science、Cochrane Library，获取有关雷公藤治疗免疫疾病的文献，并使用Revman、Stata软件进行Meta及网状Meta分析。结果 共计纳入39项文献，涉及15种疾病。结果显示雷公藤制剂联合治疗免疫疾病时显著提高疗效、CD4⁺/CD8⁺水平，显著降低不良反应发生率、免疫球蛋白M（IgM）、C-反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）水平；雷公藤多苷片联合依那西普治疗类风湿性关节炎时，疗效最佳，雷公藤多苷片联合甲氨蝶呤治疗类风湿性关节炎时，不良反应发生率最低。结论 雷公藤制剂治疗免疫疾病时，能有效提高疗效及安全性，但由于纳入研究的局限性，未来仍需要进行更多的高质量、大样本、多中心的各类雷公藤制剂治疗各类免疫疾病的研究，以更好的评价其功效。

Objective To systematic evaluate the clinical efficacy and the safety of the combined therapy of Tripterygium wilfordii preparations in the treatment of immune diseases. Methods Randomized controlled trials (RCTs) of the combined therapy of T. wilfordii preparations were collected from China National Knowledge Infrastructure (CNKI), Wanfang, VIP, Pubmed, Web of Science and Cochrane library and Meta-analysis and network Meta-analysis were performed. Results A total of 39 RCTs were included involving 15 diseases. The result shows that the combined therapy of T. wilfordii preparations could obviously enhance the clinical efficacy and the level of CD4⁺/CD8⁺, obvious reduce the incidence of adverse reactions and the level of IgM, CRP and TNF-α. When tripterygium glycosides tablets are combined with etanercept in the treatment of rheumatoid arthritis, the clinical efficacy was the best. When tripterygium glycosides tablets are combined with methotrexate in the treatment of rheumatoid arthritis, the incidence of adverse reactions is the lowest. Conclusion T. wilfordii preparations could effectively enhance the clinical efficacy and reduce the incidence of adverse reactions when treating immune diseases. And due to the limitation of the included studies, more high-quality, large-sample, and multi-center RCTs are still needed to better evaluate the curative effect and the safety of the combined therapy with T. wilfordii preparations.

R979.5

上海申康医院发展中心医企融合创新支撑技能培训专项项目（SHDC2023CRS026）；上海中医药大学附属龙华医院第二批药剂人才培养计划（RC2020-03-06）