Ib Meta-kev tshuaj ntsuam ntawm Randomized Tswj Kev sim ntawm Cistanche Decoction hauv Kev Kho Mob Rheumatoid Arthritis

Hu rau: Audrey Hu Whatsapp / hp: 0086 13880143964 Email:audrey.hu@wecistanche.com

Hai-Yu Wang, Chen-Hui Song, Fang-Kai Li, Xiao-Ping Liu, Wei Zhen 1, Yu-Ting Zhang, Yue-Lan Zhu, Xiu-Juan Hou

Qhov tseem ceeb

Cov kab lus systematically ntsuam xyuas qhov ua tau zoo thiab kev nyab xeeb ntawmCistancheDecoction ua ke nrog western tshuaj thiab western tshuaj ib leeg nyob rau hauv kev kho mob ntawm rheumatoid mob caj dab. Cov txiaj ntsig ntawm qhov kev tshuaj ntsuam meta no tau pom tiasCistancheDecoction ua ke nrog cov tshuaj sab hnub poob muaj qee qhov zoo ntawm cov tsos mob thiab kuaj ntsuas ntawm rheumatoid mob caj dab.

Abstract

Lub Hom Phiaj: Txhawm rau ntsuas qhov ua tau zoo thiab kev nyab xeeb ntawmCistanche Decoction ua ke nrog western tshuaj thiab western tshuaj ib leeg nyob rau hauv kev kho mob ntawm rheumatoid mob caj dab. Cov txheej txheem: Cov ntaub ntawv ntawm CNKI, VIP, Wanfang Cov Ntaub Ntawv, PubMed, Medline, Cochrane Library, thiab Embase tau muab los ntawm computers. Cov ntaub ntawv pov thawj ntawm cov kev tshawb fawb suav nrog, cov lus tshaj tawm cuam tshuam, thiab cov rooj sib tham rooj plaub raug muab khaws cia. Lub sijhawm tshawb nrhiav yog los ntawm cov ntaub ntawv pib txog thaum Lub Xya Hli 2017. Kev tshawb nrhiav thiab tshuaj ntsuam xyuas tau ua raws li 2 tus kws tshawb fawb, thiab cov ntaub ntawv zoo thiab cov ntaub ntawv raug soj ntsuam thiab muab rho tawm raws li Jadad qhov ntsuas zoo. Meta-analysis tau ua nrog RevMan5.3 software. Cov txiaj ntsig: (1) Tag nrho ntawm 7 qhov kev sim tshuaj ntsuam xyuas randomized thiab 485 tus neeg mob tau sau npe, ntawm 262 tus neeg mob nyob hauv pawg sim thiab 223 tus neeg mob nyob hauv pawg tswj hwm. Cov ntsiab lus ntawm 2 kev tshawb fawb yog 3, lwm yam kev tshawb fawb yog 1-2. Cov kev tshawb fawb suav nrog qhia tias pawg hauv paus ntsiab lus sib piv. (2) Tag nrho cov txiaj ntsig zoo ntawmCistancheDecoction nrog pab pawg tshuaj sab hnub poob siab dua li ntawm pawg tshuaj sab hnub poob (RR {{{0}}}.85, 95 feem pua ​​CI [0.78, 0.92]. (MD=-2.79, 95%) CI [-3.47, -2.12]); erythrocyte sedimentation tus nqi (MD=-9.5, 95 feem pua ​​CI [15.67 , -3.33]); thiab C-reactive protein (MD=-3.36, 95 feem pua ​​CI [-5.45, -1.27])) yog superior rau Tsis muaj qhov sib txawv tseem ceeb ntawm cov kev mob tshwm sim ntawm cov tshuaj thiab cov kab mob rheumatoid ntawm ob pawg.CistancheDecoction nrog cov tshuaj sab hnub poob muaj qhov zoo hauv kev txo cov tsos mob thiab kuaj ntsuas ntawm cov neeg mob rheumatoid mob caj dab. Txawm hais tias qhov zoo ntawm cov kev tshawb fawb suav nrog tsawg thiab muaj peev xwm tshaj tawm kev tsis ncaj ncees tau tshwm sim, ntxiv ntau qhov chaw ob qhov muag tsis pom kev randomized tswj kev sim nrog cov qauv loj dua yog xav tau.

Ntsiab lus: Rheumatoid mob caj dab,CistancheDecoction, Meta-analysis

Keeb kwm

Rheumatoid mob caj dab (RA) yog ib qho ntawm feem ntau inflammatory arthritis [1], ntev lub sij hawm mob, lub siab dua qhov kev tsis taus, uas feem ntau coj ib tug economist lub nra thiab lub hlwb kev nyuaj siab rau cov neeg mob thiab tsev neeg. Yog li ntawd, nws yuav muaj txiaj ntsig zoo los xaiv qhov kev kho kom zoo thiab muaj txiaj ntsig zoo rau cov neeg mob RA los txhim kho lub neej zoo thiab txo qis kev lag luam thiab lub nra hnyav. Tus kab mob no tsis muaj txoj hauv kev los kho tam sim no, thiab cov tshuaj uas tsis yog-steroidal anti-inflammatory, cov kab mob hloov kho cov tshuaj tiv thaiv kab mob, glucocorticoids, cov tshuaj lom neeg, thiab lwm yam tshuaj siv hauv chaw kho mob yuav ua rau muaj kev cuam tshuam tsis zoo [2]. kev kho mob mus ntev ntawm tus kab mob no. Suav tshuaj muaj txiaj ntsig zoo hauv kev kho tus kab mob.CistancheDecoction los ntawm Leizhengzhicai yog ib tug classic tshuaj nyob rau hauv kev kho mob ntawm RA induced los ntawm txias thiab dampness. Tam sim no, ntau qhov kev tshawb fawb tau ua pov thawj qhov ua tau zoo thiab kev nyab xeeb ntawmCistancheDecoction ua ke nrog cov tshuaj sab hnub poob hauv kev kho mob ntawm RA [3]. Vim yog cov qauv me me, qhov tseem ceeb hauv kev kho mob ntawm kev taw qhia kev kho mob yog txwv. Nyob rau hauv txoj kev tshawb no, cov txheej txheem meta-analysis tau siv los ntsuas qhov ua tau zoo thiab kev nyab xeeb ntawmCistancheDecoction ua ke nrog cov tshuaj sab hnub poob hauv kev kho mob ntawm RA, thiab muab qee cov pov thawj rau kev kuaj mob thiab kev kho mob.

Cov ntaub ntawv thiab cov txheej txheem

Cov txheej txheem suav nrog thiab cais tawm

Hom kev kawm. Randomized controlled trials (RCTs) luam tawm hauv tsev thiab txawv teb chaws thiab cov lus txwv rau Suav thiab Askiv. Cov kev kawm. Tag nrho cov xwm txheej suav nrog tau ua raws li cov txheej txheem kuaj mob rau RA tsim hauv Tebchaws Meskas hauv xyoo 1987. Suav kev kho mob syndrome, hnub nyoog, thiab poj niam txiv neej tsis txwv. Cov txheej txheem cais tawm: (1) Cov poj niam cev xeeb tub thiab lactating poj niam. (2) Cov neeg tsis haum tshuaj. (3) Cov neeg mob uas mob siab heev thiab lub raum ua haujlwm thiab hematopoietic system puas. (4) Cov neeg muaj kev puas siab puas ntsws. (5) Cov ntaub ntawv tsis muaj cov ntawv sau tag nrho. Kev ntsuas kev cuam tshuam. Cov neeg mob hauv pawg sim tau muabCistancheDecoction ua ke nrog kev kho mob sab hnub poob. Pawg tswj hwm tau kho nrog cov tshuaj sab hnub poob ib leeg. Cov tshuaj sab hnub poob siv nyob rau hauv ob pawg yog tib yam nkaus. Cov tshuaj sab hnub poob txawv los yog ua ke nrog lwm cov tshuaj suav tshuaj suav tshuaj thiab kev kho zaws raug tshem tawm. Cov txiaj ntsig ntsuas. Qhov ntsuas tau zoo: tag nrho cov txiaj ntsig zoo; Kev soj ntsuam ntau qhov ntsuas: thaum sawv ntxov tawv nqaij, kev sib tw sib koom suav. Cov ntsuas tseem ceeb hauv chav kuaj: erythrocyte sedimentation tus nqi (ESR), C-reactive protein (CRP). Cov tshuaj tiv thaiv tsis zoo: ntshav toxicity, gastrointestinal reactions, siab thiab raum raug mob, thiab lwm yam

Nrhiav tswv yim

Txhawm rau khaws cov ntaub ntawv luam tawm hauv tsev thiab txawv teb chaws. Cov ntaub ntawv khaws tseg ntawm CNKI, VIP, Wanfang, PubMed, Medline, Cochrane lub tsev qiv ntawv, thiab Embase tau tshawb xyuas los ntawm cov ntaub ntawv pib txog thaum Lub Xya Hli 2017. Nyob rau tib lub sijhawm, cov ntaub ntawv xa mus rau cov ntaub ntawv kuj tau muab rov qab. Cov lus tshawb nrhiav tau siv: #1CistancheDecoction, #2 Rheumatoid Arthritis (RA), #3 "randomized controlled trials" LOSSIS "random" LOSSIS "tswj" LOSSIS "sim", #4 #1 thiab #2 thiab #3.

Kev tshuaj xyuas cov ntaub ntawv suav nrog

Ob tug kws tshawb fawb ntawm nws tus kheej ua tiav cov ntaub ntawv tshuaj ntsuam xyuas thiab rho tawm cov ntaub ntawv. Nyob rau hauv rooj plaub ntawm kev tsis pom zoo, lawv tau sib tham los mus rau qhov kev pom zoo. Los ntawm kev nyeem cov npe thiab cov ntsiab lus ntawm cov ntaub ntawv, cov ntaub ntawv tsis ua raws li cov txheej txheem suav nrog tau pib tshuaj xyuas. Rau cov ntaub ntawv uas yuav ua tau raws li cov txheej txheem suav nrog, nws yuav tsum tau nyeem tag nrho cov ntawv los txiav txim siab seb puas yuav suav nrog. Yog tias qhov kev xav tsis sib haum, nws yuav txiav txim siab los ntawm cov neeg sab nrauv uas paub txog hauv pab pawg.

Cov ntaub ntawv Extraction thiab zoo

Kev ntsuam xyuas Qhov zoo ntawm cov kev tshawb fawb suav nrog tau soj ntsuam los ntawm kev hloov kho Jadad qhov ntsuas qhov zoo [4] (tsis zoo: 1-3 cov ntsiab lus, siab zoo: 4-7 cov ntsiab lus). Cov ntsiab lus kev ntsuam xyuas: (1) tiam ntawm random sequences; (2) faib cov zais; (3) txoj kev dig muag; (4) tawm / poob rau kev rov qab los. Txoj kev ntsuam xyuas zoo tau ua los ntawm ob tus neeg saib xyuas nws tus kheej. Yog tias tsis pom zoo, tus thib peb yuav sib tham thiab daws nws.

Cov txheej txheem txheeb cais

Meta-kev tshuaj xyuas ntawm cov txiaj ntsig tau muab rho tawm tau ua los ntawm Rev Man 5.3 software muab los ntawm Cochrane Collaboration Network. Qhov sib txawv tsis tu ncua tau sawv cev raws li qhov sib txawv (MD), tus qauv ntsuas qhov sib txawv (SMD) tau siv thaum qhov ntsuas ntsuas ntawm qhov ntsuas qhov ntsuas tau sib txawv; tus txheeb ze kev pheej hmoo (RR) lossis qhov sib txawv piv txwv (OR) tau siv rau cov ntaub ntawv dichotomous, nrog 95 feem pua ​​​​kev ntseeg siab lub sijhawm (CI). I2 < 50="" feem="" pua="" ​​​​hais="" tias="" tsis="" muaj="" kev="" txheeb="" cais="" ntawm="" cov="" kev="" tshawb="" fawb,="" thiab="" cov="" qauv="" kev="" ua="" haujlwm="" ruaj="" khov="" tau="" txais="" yuav,="" thiab="" i2=""> 50 feem pua ​​​​hais tias qhov heterogeneity muaj nyob rau hauv txoj kev tshawb no, thiab random-effects qauv tau saws; P <0.05 tau="" suav="" tias="" yog="" qhov="" tseem="">

Cov txiaj ntsig

Cov yam ntxwv ntawm cov kev tshawb fawb suav nrog

Peb tau tshuaj xyuas 54 cov ntawv nyeem pib thiab 7 cov ntawv nyeem tau suav nrog thaum kawg [5-11]. Daim ntawv qhia kev khiav dej num ntawm cov txheej txheem kev tshuaj xyuas cov ntaub ntawv tau pom nyob rau hauv daim duab 1, thiab cov yam ntxwv ntawm cov ntaub ntawv tau qhia hauv Table 1.

Kev soj ntsuam zoo

Nyob rau hauv txoj kev tshawb no, tag nrho ntawm 7 daim ntaub ntawv suav nrog. Kev ntsuam xyuas zoo ntawm tag nrho cov ntaub ntawv tau ua raws li Jadad zoo nplai. Ntawm lawv, muaj 2 daim ntawv nyeem nrog 3 ntsiab lus [7-8], thiab cov ntawv nyeem ntxiv yog 1-2 cov ntsiab lus [5-6, 9-11]. Tag nrho cov ntaub ntawv suav nrog xa mus rau randomization, ntawm plaub qhov kev tshawb fawb tau qhia txog txoj kev randomization [5, 7-8, 10]. Tsis muaj ib qho ntawm xya txoj kev tshawb fawb xa mus rau kev faib zais zais thiab qhov muag tsis pom kev. Xya qhov kev tshawb fawb tau randomized thiab qhia tau hais tias lub hauv paus ntawm cov pab pawg tau muab piv, tsis muaj cov ntaub ntawv qhia tsis tiav, thiab cov ntawv qhia xaiv tau. Cov qauv tsim tshwj xeeb thiab kev soj ntsuam zoo tau pom nyob rau hauv Table 2.

Meta-analysis hav zoov daim ntawv qhia ntawm CRP nyob rau hauv ob pawg. CRP tau tshaj tawm hauv 3 cov ntaub ntawv [7-9]. Meta-analysis pom tias pawg sim tau zoo tshaj rau pawg tswj hwm hauv nam ntawm CRP, thiab qhov sib txawv yog qhov tseem ceeb. (MD=-3.36, 95 feem pua ​​CI [-5.45, -1.27], P=0.202) (Daim duab 3).

Meta-analysis hav zoov daim ntawv qhia ntawm ob pawg ntawm ESR. ESR tau tshaj tawm hauv 3 cov ntaub ntawv [7-9]. Meta-analysis pom tau tias pawg sim tau zoo tshaj rau pawg tswj hwm hauv ESR, thiab qhov sib txawv yog qhov tseem ceeb. (MD=-9.5, 95 feem pua ​​CI [15.67, -3.33], P=0.003) (Daim duab 4).

Meta-analysis hav zoov daim ntawv qhia ntawm kev sib tw sib tw suav. Kev sib tw suav suav tau tshaj tawm hauv 3 kab lus [6-8]. Cov txiaj ntsig ntawm meta-kev tshuaj ntsuam pom tau tias qhov sib koom ua ke ntawm cov kev sib tw ntawm pawg sim tau tsawg dua li ntawm pawg tswj hwm. (MD=-2.79, 95 feem pua ​​CI [-3.47, -2.12]), P < 0.001)="" (daim="" duab="">

Meta-analysis hav zoov daim ntawv qhia ntawm rheumatoid yam nyob rau hauv ob pawg. Rheumatoid factor (RF) tau tshaj tawm hauv 3 kab lus [7-8]. Cov txiaj ntsig ntawm kev tshuaj ntsuam xyuas meta pom tau tias RF hauv pab pawg sim tsis muaj qhov tseem ceeb hauv kev sib piv nrog pawg tswj hwm (SMD=-0.17, 95 feem pua ​​​​CI [-0.50, 0.16]] , P=0.31) (Daim duab 6).

Meta-analysis hav zoov daim ntawv qhia ntawm qhov tshwm sim ntawm kev tsis zoo tshwm sim hauv 2 pawg. Cov xwm txheej tsis zoo tau tshaj tawm hauv 2 cov ntawv nyeem [7-8]. Meta-analysis qhia tias tsis muaj qhov sib txawv ntawm pawg sim thiab pawg tswj hwm (OR=1.23, 95 feem pua ​​​​CI [0. 05, 28.89], P=0. 90) (Daim duab 7)

Kev tshaj tawm kev tsis ncaj ncees thiab kev tsom xam rhiab heev

Inverted funnel zajlus ntawm publishing bias. Lub funnel zaj duab xis hais txog tag nrho cov txiaj ntsig ntawmCistancheDecoction ua ke nrog cov pab pawg neeg sab hnub poob thiab cov tshuaj sab hnub poob ib leeg kho RA tau tsim los ua cov ntawv tshaj tawm tsis ncaj ncees. Cov phiaj xwm funnel ntawm tag nrho cov txiaj ntsig tau zoo yog asymmetric, qhia txog qhov muaj peev xwm ntawm kev tshaj tawm kev tsis ncaj ncees, uas qhia txog qhov tsis zoo ntawm cov kev tshawb fawb suav nrog. Qhov no yuav cuam tshuam nrog qhov tseeb tias cov txiaj ntsig tsis zoo tsis suav nrog thiab cov txiaj ntsig zoo tau yooj yim luam tawm (Daim duab 8). Vim tias tus naj npawb ntawm ESR, CRP, kev sib koom ua ke, thiab cov tshuaj tiv thaiv tsis zoo muaj tsawg dua 4, qhov kev soj ntsuam funnel ntawm nws qhov kev tsis ncaj ncees ntawm kev tshaj tawm tsis tau ua.

Kev tsom xam rhiab heev. Cov txiaj ntsig ntawm meta-kev tshuaj xyuas ntawm tag nrho cov txiaj ntsig tau zoo, CRP, kev sib koom ua ke suav, cov tshuaj tiv thaiv tsis zoo, kev soj ntsuam kev xav ntawm cov qauv siv tsis tau hloov pauv cov txiaj ntsig ntawm kev tshuaj ntsuam meta. Qhov no qhia tau hais tias cov txiaj ntsig ntawm kev tshawb fawb tau ntseeg tau. Tab sis cov txiaj ntsig tshwm sim ntawm ESR thiab RF tau hloov pauv, uas qhia txog qhov tsis ruaj khov uas muaj nyob rau hauv kev tshuaj ntsuam meta. Cov txiaj ntsig ntawm kev txheeb xyuas qhov tshwj xeeb tau pom nyob rau hauv Table 3.

Kev sib tham

Methodological Quality of Literature

Xya qhov kev tshawb fawb suav nrog yog qhov tsis zoo raws li Jadad qhab nia zoo. Tsuas yog peb daim ntawm cov ntaub ntawv xa mus rau random thiab tsis tau hais txog cov txheej txheem tshwj xeeb ntawm randomization. Tag nrho cov ntaub ntawv tsis tau hais txog kev faib zais zais thiab qhov muag tsis pom kev. Qhov tsis muaj txoj hauv kev dig muag tej zaum yuav cuam tshuam rau kev siv tshuaj suav tshuaj decoction, uas nyuaj rau qhov muag tsis pom hauv tsev kho mob. Feem ntau ntawm cov kev tshawb fawb tsis tau hais txog kev taug qab thiab poob rau kev taug qab, uas cuam tshuam rau cov ntaub ntawv zoo. Txoj kev tshawb fawb tseem pom tau tias cov txiaj ntsig tsis zoo ntawm cov ntaub ntawv muaj tsawg, thiab qee qhov kev tshaj tawm tsis zoo yuav tshwm sim.

Curative nyhuv tsom xam

CistancheDecoction yog los ntawm Leizhengzhicai, nyob rau hauv uasCistanche(Coicis Semen) thiab Cangzhu (Atractylodes Rhizoma) tuaj yeem ua kom tus po thiab dehumidify; Duhuo (Angelicae Pubescentis Radix), Qianghuo (Notopterygh Rhizoma Et Radix), thiab Fangfeng (Saposhnikoviae Radix) tuaj yeem tshem tawm cua thiab kov yeej kev ntub dej; Chuanwu (Aconiti Radix), Mahuang (Ephedra Herba) thiab Guizhi (Cinnamomi Ramulus) tuaj yeem sov thiab qhib meridian, dissipate txias thiab dispel dampness; Danggui (Angelicae Sinensis Radix) thiab Chuanxiong (Chuanxiong Rhizoma) tuaj yeem txhawb nqa cov ntshav thiab txhawb kev ncig ntawm qi; Shengjiang (Zingiberis Rhizoma Tsis ntev los no), thiab Gancao (Glycyrrhizae Radix Et Rhizoma) tuaj yeem ua kom lub plab mog thiab tswj lub nruab nrab sov, zam kev phem thiab khaws cia lub zog tseem ceeb. Tag nrho cov tshuaj sib xyaw ua ke tuaj yeem ua kom txias, tshem tawm dampness thiab ua kom meridians kom tsis txhob mob. Nws tau tshaj tawm tiasCistancheDecoction tuaj yeem cuam tshuam lub pob ntseg mob tshwm sim los ntawm xylene, thiab txo qis permeability ntawm capillaries thiab PGE2 cov ntsiab lus ntawm cov ntaub so ntswg inflammatory, uas muaj cov tshuaj tiv thaiv zoo thiab tshuaj tua kab mob.Cistanche(Coicis Semen) yog qab zib, tsis qab, thiab txias nyob rau hauv qhov, uas yuav tshem tawm dampness, txhawb diuresis, invigorate tus po, tsis txhob raws plab, kho rheumatism, thiab tshem tawm cov kua mis. Kev tshawb fawb qhia tiasCistancheactive ingredient coixenolide tuaj yeem nce qhov feem ntawm Foxp3 ntxiv , CD4 ntxiv , CD25 ntxiv , thiab Treg hauv collagen-induced mob caj dab nas, uas tej zaum yuav muaj kev tiv thaiv kab mob hauv RA [13]. Txoj kev tshawb no tau ntsuas qhov ua tau zoo ntawmCistancheDecoction ua ke nrog western tshuaj nyob rau hauv kev kho mob ntawm RA los ntawm meta-analysis txoj kev ntawm phau ntawv Cochrane. Cov txiaj ntsig tau pom tias tag nrho cov txiaj ntsig tau zoo, CRP, ESR, kev sib tw sib koom ua ke, thiab lub sijhawm thaum sawv ntxov nruj hauvCistancheDecoction ua ke nrog cov tshuaj sab hnub poob tau zoo dua li cov hauv pawg tshuaj sab hnub poob. Hauv qhov nam ntawm RF thiab qhov tshwm sim ntawm qhov tshwm sim tsis zoo, qhov sib txawv tsis yog qhov tseem ceeb. Ua raws li kev txwv ntawm cov ntaub ntawv suav nrog, nws yuav tsum tau tsim kom muaj ntau qhov chaw, random, ob qhov muag tsis pom, thiab cov qauv loj rau kev kawm kom muaj pov thawj ntau dua.

Cov kev txwv ntawm qhov kev ntsuam xyuas qhov system

(1) Txoj kev dig muag hauv cov ntaub ntawv suav nrog tsis tau txais, uas yuav muaj kev cuam tshuam puas siab puas ntsws rau cov neeg mob thiab cuam tshuam ntxiv rau kev kho mob. (2) Cov ntaub ntawv tseem ceeb ntawm ntau yam ntaub ntawv tsis tiav thiab tsis tuaj yeem tau txais tom qab hu rau cov kws sau ntawv los ntawm E-mail, uas cuam tshuam rau kev nkag siab ntawm cov ntaub ntawv. (3) Cov xwm txheej tsis txaus ntseeg ntawm cov kev sim sib txawv ntawm cov kev sim uas muaj nyob hauv yuav cuam tshuam rau qhov tseeb thiab kev ntseeg siab ntawm txoj kev tshawb fawb.

Qhov tseem ceeb rau kev tshawb fawb yav tom ntej

Nyob rau hauv xyoo tas los no, kev tshawb fawb txog Suav tshuaj hauv kev kho mob ntawm RA tau txais ntau thiab ntau dua, tab sis qhov zoo ntawm cov txheej txheem tseem yuav tsum tau txhim kho. Cov ntaub ntawv pov thawj-raws li cov tshuaj yuav tsum tau muaj kev kawm RCT zoo, tab sis tsuas yog ob ntawm xya daim ntawv nyeem suav nrog hauv txoj kev tshawb no tau raug ntsuas raws li 3 cov ntsiab lus raws li Jadad qhov ntsuas qhov zoo, lwm qhov yog 1 txog 2 cov ntsiab lus, thiab qhov zoo ntawm cov ntaub ntawv. cov ntaub ntawv tsis tshua muaj dav. Yog li ntawd, nws raug pom zoo tias cov kev tshawb fawb tseem ceeb yav tom ntej yuav tsum qhia meej txog cov txheej txheem tiam ntawm kev sib txawv; qhov kev ntsuas zais ntawm cov kev faib nyiaj random; Txoj kev dig muag lossis kev tswj cov placebo yuav tsum tau siv; tshem tawm los yog poob rau kev rov qab los; kev ncaj ncees ntawm cov ntaub ntawv xeem yuav tsum tau ua kom tsis txhob xaiv cov txiaj ntsig tau tshaj tawm, thiab taug qab cov tshuaj tsis zoo. Ua kom muaj tseeb thiab kev ntseeg siab ntawm cov txiaj ntsig kev tshawb fawb kom deb li deb tau.

Cov ntaub ntawv

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