{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T03:32:39Z","timestamp":1778124759704,"version":"3.51.4"},"reference-count":54,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,5,15]],"date-time":"2020-05-15T00:00:00Z","timestamp":1589500800000},"content-version":"vor","delay-in-days":135,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81804218"],"award-info":[{"award-number":["81804218"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Evidence-Based Complementary and Alternative Medicine"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:p><jats:italic>Objectives<\/jats:italic>. To systematically evaluate the efficacy and safety of sinomenine preparation (SP) for treating ankylosing spondylitis (AS). <jats:italic>Methods<\/jats:italic>. Clinical randomized controlled trials (RCTs) of SP for treating AS were systematically identified in six electronic databases including PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), and Wanfang Databases from the inception up to 31 October 2019. Cochrane\u2019s risk of bias tool was used to assess the methodological quality and Review Manager 5.3 software was used to analyze data. <jats:italic>Results<\/jats:italic>. A total of 12 RCTs involving 835 patients were finally included. According to interventions, RCTs were divided into two types. The intervention in 10 RCTs was SP combined with conventional pharmacotherapy (CPT) versus CPT and that in 2 RCTs was SP alone versus CPT. The results of the meta\u2010analysis showed that, compared with CPT alone, SP combined with oral CPT has better improvement in BASDAI (WMD\u2009=\u2009\u22121.84, 95% CI [\u22123.31, \u22120.37], <jats:italic>P<\/jats:italic> = 0.01), morning stiffness time (WMD\u2009=\u2009\u221213.46, 95% CI [\u221216.12, \u221210.79], <jats:italic>P<\/jats:italic> &lt; 0.00001), the Schober test (WMD\u2009=\u20091.26, 95% CI [0.72, 1.80], <jats:italic>P<\/jats:italic> &lt; 0.00001), the occipital wall test (WMD\u2009=\u2009\u22120.55, 95% CI [\u22120.96, \u22120.14], <jats:italic>P<\/jats:italic> = 0.009), the finger\u2010to\u2010ground distance (WMD\u2009=\u2009\u22123.28, 95% CI [\u22125.64, \u22120.93], <jats:italic>P<\/jats:italic> = 0.006), 15\u2009m walking time (WMD\u2009=\u2009\u22128.81, 95% CI [\u221213.42, \u22124.20], <jats:italic>P<\/jats:italic> = 0.0002), the C\u2010reactive protein (CRP) (WMD\u2009=\u2009\u22121.84, 95% CI [\u22123.24, \u22120.45], <jats:italic>P<\/jats:italic> = 0.01), and the total effective rate (RR\u2009=\u20091.10, 95% CI [1.01, 1.20], <jats:italic>P<\/jats:italic> = 0.03). Besides, it also showed that oral SP alone may be more effective in improving morning stiffness time (WMD\u2009=\u2009\u221231.89, 95% CI [\u221234.91, \u221228.87], <jats:italic>P<\/jats:italic> &lt; 0.00001) compared with CPT alone. However, this study cannot provide evidence that loading the injectable SP based on CPT can significantly increase the efficacy due to the insufficient number of studies included. In terms of adverse events, there was no statistically significant difference between the experimental group and the control group. <jats:italic>Conclusions<\/jats:italic>. This study shows that oral SP may be effective and safe in the treatment of AS. Due to the low methodological quality of the included RCTs and the limitations of the meta\u2010analysis, it is still necessary to carry out more multicenter, large\u2010sample, and high\u2010quality RCTs to further verify the conclusions. The review protocol was registered on PROSPERO (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/www.crd.york.ac.uk\/prospero\/display_record.php?RecordID=99170\">CRD42018099170<\/jats:ext-link>), and the review was constructed following the PRISMA guidelines (Annex 1).<\/jats:p>","DOI":"10.1155\/2020\/4593412","type":"journal-article","created":{"date-parts":[[2020,5,16]],"date-time":"2020-05-16T00:27:30Z","timestamp":1589588850000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Efficacy and Safety of Sinomenine Preparation for Ankylosing Spondylitis: A Systematic Review and Meta\u2010Analysis of Clinical Randomized Controlled Trials"],"prefix":"10.1155","volume":"2020","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0702-6540","authenticated-orcid":false,"given":"Shan-Shan","family":"Lin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4063-3729","authenticated-orcid":false,"given":"Chun-Xiang","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4043-1967","authenticated-orcid":false,"given":"Jun-Hua","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4234-2151","authenticated-orcid":false,"given":"Hui","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing-Bo","family":"Zhai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9882-7406","authenticated-orcid":false,"given":"Jing-Yuan","family":"Mao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6160-5650","authenticated-orcid":false,"given":"Xian-Liang","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,5,15]]},"reference":[{"key":"e_1_2_10_1_2","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-210770"},{"key":"e_1_2_10_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(11)60071-8"},{"key":"e_1_2_10_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780270401"},{"key":"e_1_2_10_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.20990"},{"key":"e_1_2_10_5_2","first-page":"780","article-title":"Ankylosing spondylitis: an update","volume":"42","author":"Golder V.","year":"2013","journal-title":"Australian Family Physician"},{"key":"e_1_2_10_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-017-3660-3"},{"key":"e_1_2_10_7_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2015.13"},{"key":"e_1_2_10_8_2","first-page":"77","article-title":"Research progress of ankylosing spondylitis","volume":"4","author":"Feng F.","year":"2015","journal-title":"Rheumatoid Arthritis"},{"key":"e_1_2_10_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-209209"},{"key":"e_1_2_10_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-204055"},{"key":"e_1_2_10_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2019-216034"},{"key":"e_1_2_10_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.41042"},{"key":"e_1_2_10_13_2","first-page":"557","article-title":"Ankylosing spondylitis diagnosis and treatment guide","volume":"14","author":"Chinese Medical Association Rheumatology Branch","year":"2010","journal-title":"Chinese Journal of Rheumatology"},{"key":"e_1_2_10_14_2","first-page":"763","article-title":"Guidelines and progress in the treatment of ankylosing spondylitis","volume":"3","author":"Yu G.","year":"2014","journal-title":"Chinese Journal of Bone and Joint Injury"},{"key":"e_1_2_10_15_2","doi-asserted-by":"publisher","DOI":"10.1080\/14740338.2016.1240783"},{"key":"e_1_2_10_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000007145"},{"key":"e_1_2_10_17_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa050493"},{"key":"e_1_2_10_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60900-9"},{"key":"e_1_2_10_19_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j1909"},{"key":"e_1_2_10_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-019-04277-w"},{"key":"e_1_2_10_21_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms20010070"},{"key":"e_1_2_10_22_2","first-page":"1040","article-title":"Research progress on anti-inflammatory and anti-tumor effects of sinomenine","volume":"31","author":"Sun Y. H.","year":"2018","journal-title":"Chinese Pharmacological Bulletin"},{"key":"e_1_2_10_23_2","first-page":"81","article-title":"Research progress on pharmacological effects of sinomenine","volume":"30","author":"Qin F.","year":"2016","journal-title":"Chinese Medical Journal"},{"key":"e_1_2_10_24_2","first-page":"193","article-title":"Research progress of immunosuppression and anti-inflammatory activity of sinomenine","volume":"32","author":"Zhang X. Y.","year":"2016","journal-title":"Hunan Journal of Traditional Chinese Medicine"},{"key":"e_1_2_10_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.intimp.2010.11.018"},{"key":"e_1_2_10_26_2","doi-asserted-by":"publisher","DOI":"10.1691\/ph.2017.6946"},{"key":"e_1_2_10_27_2","doi-asserted-by":"publisher","DOI":"10.1038\/aps.2013.139"},{"key":"e_1_2_10_28_2","doi-asserted-by":"publisher","DOI":"10.3109\/08923973.2015.1046991"},{"key":"e_1_2_10_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejphar.2013.09.062"},{"key":"e_1_2_10_30_2","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/910376"},{"key":"e_1_2_10_31_2","doi-asserted-by":"publisher","DOI":"10.19540\/j.cnki.cjcmm.20180419.006"},{"key":"e_1_2_10_32_2","doi-asserted-by":"publisher","DOI":"10.3390\/molecules21111520"},{"key":"e_1_2_10_33_2","doi-asserted-by":"publisher","DOI":"10.12659\/msm.907589"},{"key":"e_1_2_10_34_2","first-page":"2286","article-title":"A new approach to defining disease status in ankylosing spondylitis: the Bath Ankylosing Spondylitis Disease Activity Index","volume":"21","author":"Garrett S.","year":"1994","journal-title":"Journal of Rheumatology"},{"key":"e_1_2_10_35_2","first-page":"2281","article-title":"A new approach to defining functional ability in ankylosing spondylitis: the development of the Bath Ankylosing Spondylitis Functional Index","volume":"21","author":"Calin A.","year":"1994","journal-title":"Journal of Rheumatology"},{"key":"e_1_2_10_36_2","first-page":"317","article-title":"Erythrocyte sedimentation rate and C-reactive protein measurements and their relevance in clinical medicine","volume":"115","author":"Bray C.","year":"2016","journal-title":"WMJ"},{"key":"e_1_2_10_37_2","first-page":"611","article-title":"Baseline interleukin-6 and erythrocyte sedimentation rate can predict clinical response of TNF inhibitor treatment in patients with ankylosing spondylitis","volume":"49","author":"Dong Y.","year":"2019","journal-title":"Annals of Clinical and Laboratory Science"},{"key":"e_1_2_10_38_2","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions, Version 5.1.0","author":"Higgins J. P. T.","year":"2011"},{"key":"e_1_2_10_39_2","first-page":"615","article-title":"Clinical observation on active ankylosing spondylitis treated with a combination of traditional Chinese and Western medicines","volume":"8","author":"Liu J. Z.","year":"2001","journal-title":"Chinese Journal of Integrated Traditional and Western Medicine"},{"key":"e_1_2_10_40_2","first-page":"4272","article-title":"Effects of combined treatment of traditional Chinese medicine and Western medicine to ameliorate pains and joint motion of patients with ankylosing spondylitis","volume":"21","author":"Liu F. H.","year":"2004","journal-title":"Chinese Journal of Clinical Rehabilitation"},{"key":"e_1_2_10_41_2","first-page":"25","article-title":"Treatment of ankylosing spondylitis with meloxicam, salicylazosulfapyridine, and Zheng-Qiong-Feng-Tong-Ning tablet","volume":"14","author":"Dong G. F.","year":"2008","journal-title":"Guiding Journal of Traditional Chinese Medicine and Pharmacology"},{"key":"e_1_2_10_42_2","unstructured":"YangD. C.andZhengX. C. WuQ. F.andYeZ. Z. Zhengqing Fengtongning sustained-release tablets in the treatment of ankylosing spondylitis efficacy observation Proceedings of the National Symposium on the Integrative Medicine for Ankylosing Spondylitis 2007 Guangdong China 156\u2013158."},{"key":"e_1_2_10_43_2","first-page":"56","article-title":"Clinical study on treatment of ankylosing spondylitis with Zhengqing Fengtongning sustained-release tablet combined with sulfasalazine","volume":"14","author":"Huang C. B.","year":"2007","journal-title":"Chinese Journal of Information on Traditional Chinese Medicine"},{"key":"e_1_2_10_44_2","first-page":"184","article-title":"Clinical analysis of the sinomenine hydrochloride sustained release tablet on the ankylosing spondylitis","volume":"36","author":"Yin G.","year":"2009","journal-title":"Preventive Medicine"},{"key":"e_1_2_10_45_2","first-page":"756","article-title":"Clinical effects of Zhengqing Fengtongning on ankylosing spondylitis","volume":"38","author":"Lin Z. X.","year":"2010","journal-title":"Journal of Clinical Medicine"},{"key":"e_1_2_10_46_2","first-page":"127","article-title":"Effect of sinomenine combined with sulfasalazine and thalidomide on ankylosing spondylitis","volume":"18","author":"Yu S. B.","year":"2014","journal-title":"Journal of Clinical Medicine Research"},{"key":"e_1_2_10_47_2","first-page":"1429","article-title":"The effect of Zhengqingfengtongning injection into sacroiliac joint on patients with ankylosing spondylitis","volume":"18","author":"Jie L. G.","year":"2009","journal-title":"Journal of Emergency Medicine"},{"key":"e_1_2_10_48_2","first-page":"65","article-title":"Clinical observation on 25 cases of ankylosing spondylitis treated with Zhengqing Fengtongning injection combined with indomethacin","volume":"16","author":"An P.","year":"2010","journal-title":"Guiding Journal of Traditional Chinese Medicine"},{"key":"e_1_2_10_49_2","unstructured":"LiuW. ZhangL. andLiuX. Y. WuQ. F.andYeZ. Z. Treatment of ankylosing spondylitis with Zhengqing Fengtongning: clinical observation of 60 cases Proceedings of the National Symposium on the Integrative Medicine for Ankylosing Spondylitis 2007 Guangdong China 144\u2013146."},{"key":"e_1_2_10_50_2","first-page":"45","article-title":"Clinical observation on 28 cases of active ankylosing spondylitis treated by Zhengqing Fengtongning","volume":"17","author":"Chai L. M.","year":"2011","journal-title":"Guiding Journal of Traditional Chinese Medicine"},{"key":"e_1_2_10_51_2","first-page":"352","article-title":"The anti-inflammatory mechanism of sinomenine: effects of sinomenine on cyclooxygenase activity and gene expression of human peripheral blood mononuclear cells","volume":"28","author":"Wang W. J.","year":"2003","journal-title":"Chinese Journal of Materials Research"},{"key":"e_1_2_10_52_2","first-page":"506","article-title":"SPIRIT 2013 Statement: defining standard protocol items for clinical trials","volume":"38","author":"Chan A. W.","year":"2015","journal-title":"Revista Panamericana de Salud P\u00fablica"},{"key":"e_1_2_10_53_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2011.09.004"},{"key":"e_1_2_10_54_2","doi-asserted-by":"publisher","DOI":"10.1586\/erp.12.19"}],"container-title":["Evidence-Based Complementary and Alternative Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/ecam\/2020\/4593412.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/ecam\/2020\/4593412.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/2020\/4593412","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T08:25:45Z","timestamp":1723019145000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/2020\/4593412"}},"subtitle":[],"editor":[{"given":"Yuan","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2020,1]]},"references-count":54,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,1]]}},"alternative-id":["10.1155\/2020\/4593412"],"URL":"https:\/\/doi.org\/10.1155\/2020\/4593412","archive":["Portico"],"relation":{},"ISSN":["1741-427X","1741-4288"],"issn-type":[{"value":"1741-427X","type":"print"},{"value":"1741-4288","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1]]},"assertion":[{"value":"2020-02-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-04-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-05-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"4593412"}}