目的 采用网状Meta分析评价口服中成药治疗痛风性关节炎的疗效以及安全性，为痛风性关节炎的临床治疗提供循证依据。方法 计算机检索中国知网（CNKI）、万方（Wanfang）、维普（VIP）、CBM、PubMed、Cochrane Library、Web of Science等数据库，检索有关口服中成药治疗痛风性关节炎的临床随机对照试验（randomized controlled trial，RCT），检索时限为各数据库建库至2020年10月。采用Cochrane推荐的偏倚风险评估工具对纳入的RCT进行质量评价。应用R软件和GeMTC 0.14.3版本进行贝叶斯模型网状Meta分析。结果 最终纳入26篇RCT，总样本量2358例，其中试验组1307例，对照组1051例，共纳入14种口服中成药。网状Meta分析结果表明，在总有效率方面，排序前3的药物为滑膜炎颗粒联合化学药>湿热痹片（胶囊）联合化学药>黄柏胶囊联合化学药；在降低血尿酸水平方面，排序前3的药物为百令胶囊联合尿毒清颗粒>通滞苏润江胶囊>三黄胶囊联合化学药；在不良反应事件的发生方面，联合中成药的治疗方案普遍优于单纯口服化学药治疗，发生率最低的治疗方案为如意珍宝丸联合化学药。结论 痛风性关节炎口服中成药的治疗方案中，提高有效率方面首选滑膜炎颗粒联合常规口服化学药，在降低血尿酸水平上首选百令胶囊联合尿毒清颗粒；对于痛风性关节炎的诊疗应当综合评估，注重中成药与常规口服化学药的联合应用，以最佳化治疗效果及减少不良反应为基准。

Objective To evaluate the efficacy and safety of Chinese patent medicine in the treatment of gouty arthritis by network Meta-analysis, in order to provide evidence for gouty arthritis. Methods The clinical randomized controlled trials (RCT) for the treatment of gouty arthritis with Chinese patent medicine were searched from the databases of CNKI, Wanfang, VIP, CBM, PubMed, Cochrane Library, and Web of Science from the establishment of each database to October 2020. And data extraction and quality assessment were performed according to the Cochrane standards. R Project and GeMTC 0.14.3 were then used for network Meta-analysis. Results Finally, 26 RCTs with a total sample size of 2358 cases were included, including 1307 cases in the experimental group and 1051 cases in the control group and a total of 14 oral Chinese patent medicines were included. Network Meta-analysis results showed that, in terms of total effective rate, the top three drugs were Synovitis Granules (滑膜炎颗粒)＋WM (Western medicine)>Shirebi Tablets (Capsules) [湿热痹片(胶囊)]＋WM>Huangbai Capsules (黄柏胶囊) ＋WM; In terms of reducing blood uric acid level, the top three drugs were Bailing Capsules (百令胶囊)＋Niaoduqing Granules (尿毒清颗粒) >Tongzhi Surunjiang Capsules (通滞苏润江胶囊) >Sanhuang Capsules (三黄胶囊) ＋WM; In terms of adverse reaction events, the treatment combined with Chinese patent medicine was generally better than oral WM treatment alone. The lowest incidence was Ruyi Zhenbao Pill (如意珍宝丸) combined with conventional oral WM. Conclusion In conclusion, in choosing oral Chinese patent medicine for the treatment of gouty arthritis, Synovitis Granule combined with conventional oral WM is the first choice to improve the effective rate, and Bailing Capsule combined with Niaoduqing Granule is the first choice to reduce the level of blood uric acid level. And for the diagnosis and treatment of gouty arthritis should be evaluated comprehensively, paying attention to the combination of traditional Chinese medicine and conventional oral Western medicine, in order to optimize the treatment effect and reduce adverse reactions as the benchmark.

R285.64

湖南省自然科学基金项目（2019JJ50352）；湖南省中医药科研计划重点项目（201913）；长沙市科技计划项目（kq2004057）；湖南省研究生科研创新项目（CX20200800）