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一貫煎加減方治療慢性胃炎的系統評價與Meta分析
龔博煬1, 樊亞東1, 田之魁2, 崔巖3, 王瑩1, 范天慈3, 徐喆1, 邊育紅1
1.天津中醫藥大學中西醫結合學院, 天津 301617;2.天津中醫藥大學中醫健康科學與工程學院, 天津 301617;3.天津中醫藥大學中醫藥研究院 天津, 301617
摘要:
[目的] 系統評價一貫煎加減方治療慢性胃炎的臨床效果以及安全性。[方法] 首先全面檢索The Cochrane Library,Pubmed,中國知網(CNKI),維普數據庫(VIP)和萬方數據庫(WanFang),查找截至2022年2月的一貫煎治療慢性胃炎的隨機對照試驗,根據Cochrane風險偏倚評估工具對納入的文獻進行評價,采用Review Manager 5.4軟件進行定量合成。[結果] 最終納入13項研究,共1 357例患者,其中一貫煎組697例,常規組660例。Meta分析結果顯示:與常規治療方案相比,一貫煎加減方治療能有效提高慢性胃炎患者臨床療效,總有效率的合并效應量和95%的置信區間為[OR=4.86,95%CI(3.39,6.97),P < 0.000 01],并且均優于西藥組和中成藥組。此外,相較于常規治療組,一貫煎加減方可顯著提高胃鏡改善率[OR=3.43,95%CI(1.47,8.01),P < 0.000 01];提高幽門螺桿菌(Hp)轉陰率[OR=17.07,95%CI(6.62,44.04),P < 0.000 01)];改善血清胃蛋白酶原I(PGI)[MD=12.05,95%CI(8.25,15.84),P < 0.000 01];降低不良反應發生率。[結論] 根據已有研究數據,一貫煎加減方治療慢性胃炎同常規治療組相比臨床療效更佳,安全性更好,并且能提高胃鏡改善率和Hp轉陰率以及降低血清PGI水平。但由于納入文獻質量不高,結論需要更多高質量研究加以驗證。
關鍵詞:  一貫煎  慢性胃炎  隨機對照試驗  Meta分析
DOI:10.11656/j.issn.1672-1519.2023.05.14
分類號:R259
基金項目:健康中國跨領域工程科技未來20年發展戰略研究。
Systematic evaluation and Meta analysis of modified Yiguanjian for treating chronic gastritis
GONG Boyang1, FAN Yadong1, TIAN Zhikui2, CUI Yan3, WANG Ying1, FAN Tianci3, XU Zhe1, BIAN Yuhong1
1.School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China;2.College of Health Science and Engineering of Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China;3.Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
Abstract:
[Objective] To systematically evaluate the clinical effect and safety of Yiguanjian in the treatment of chronic gastritis.[Methods] First, the Cochrane Library, Pubmed, China Journal Full text Database(CNKI), China Science and Technology Journal Full text Database (VIP), Wanfang Database, etc. were comprehensively searched to find out the randomized controlled trials of the treatment of chronic gastritis with Yiguanjian as of February 2022. The included literature was evaluated according to the Cochrane risk bias assessment tool, and quantitative synthesis was carried out with the Review Manager 5.4 software.[Results] Totally 1 357 patients were included in 13 studies, including 697 patients in the Yiguanjian group and 660 patients in the routine group. Meta analysis results showed that, compared with the conventional treatment scheme, the treatment of Yiguanjian could effectively improve the clinical efficacy of patients with chronic gastritis. The combined effect amount and 95% confidence interval of the total effective rate were [OR=4.86, 95%CI(3.39, 6.97), P < 0.000 01], and both were superior to the western medicine group and the Chinese patent medicine group. In addition, compared with the conventional treatment group, the improved rate of gastroscopy was significantly increased by the addition and subtraction of Yiguanjian [OR=3.43, 95%CI (1.47, 8.01), P < 0.000 01];improve the negative rate of HP [OR=17.07, 95%CI(6.62, 44.04), P < 0.000 01)]; improve the serum PGI of pepsin[MD=12.05, 95%CI(8.25, 15.84), P < 0.000 01];reduce the incidence of adverse reactions.[Conclusion] According to the existing research data, the clinical efficacy and safety of Yiguanjian in the treatment of chronic gastritis are better than those of the conventional treatment group, and it can improve the improvement rate of gastroscope, turn negative rate of HP and reduce the level of serum PGI of pepsin. However, due to the low quality of the included literature, the conclusion needs more high-quality research to verify.
Key words:  Yiguanjian  chronic-gastritis  ranolomized controlled trial  Meta analysis
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