Efficacy of Chinese herbal medicine of Acrid-opening and Bitter-descending method on chronic atrophic gastritis:a meta-analysis of randomized controlled trials
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摘要: [目的]系统评价辛开苦降法治疗慢性萎缩性胃炎的临床疗效。[方法]从万方数据库、维普中文科技期刊数据库(VIP)、中国知网全文期刊数据库(CNKI)、Pubmed英文数据库中检索关于应用辛开苦降法治疗慢性萎缩性胃炎的临床随机对照试验(RCT)的文献,根据关键词筛选出符合纳入标准及排除标准的文献,提取数据并做质量评价后,使用ReVMan5.2软件对数据进行meta分析。[结果]经过纳入标准与排除标准筛查后,纳入15篇文献,共1744例患者,治疗组901例,对照组843例。临床疗效总有效率RR值为1.30,95%CI=1.20~1.40,Z=7.78,P＜0.01、病理疗效总有效率OR值为3.29,95%CI=2.43~4.45,Z=7.69,P＜0.01、胃镜疗效总有效率OR值为3.29,95%CI=2.43~4.45,Z=7.69,P＜0.01、根除HP疗效总有效率OR值为2.93,95%CI=1.21~7.10,Z=2.38,P＜0.05,差异均有统计学意义。[结论]可以初步认为,辛开苦降法治疗CAG在临床疗效、病理疗效、胃镜疗效的改善上优于西药治疗,而对幽门螺杆菌(Helicobacterpylori,HP)的根除疗效尚不能认为优于西药,但需要更多高质量、随机平行对照试验进一步提供数据支持。Abstract: [Objective]To systematically evaluate the effect of chronic atrophic gastritis(CAG)treated between Chinese herbal medicine based on the method of acrid opening and bitter descending and purely western medicine.[Methods]We searched all the randomized controlled trials(RCT)about Chinese herbal medicine based on the method of acrid opening and bitter descending in thre treatment of CAG from Wanfang Database,VIP Chinese Scientific Journals Database,The China National Knowledge Infrastructure(CNKI)and Pubmed Database,filtering literature based on subject terms according to inclusion criteria and exclusion standard data,extracting date as well as assessing their quality,and then used the RevMan 5.2 software for data analysis.[Results]We found out 15 articles by keywords including 1744 cases in which there are 901 cases in the experimental group and 842 cases in the control group.There was statistically significant differences between two groups on total effective rate of clinical efficacy[RR=1.30,95%CI=1.20~1.40,P＜0.01],pathological effect[OR=3.29,95%CI=2.43~4.45,Z=7.69,P＜0.01],gastroscope curative efficacy\[3.29,95%CI=2.43~4.45,Z=7.69,P＜0.01],and eradicating HP[2.93,95%CI=1.21~7.10,Z=2.38,P＜0.05].[Conclusion]We can preliminary conclude that the method of acrid opening and bitter descending in the treatment of CAG is superior to western medicine in clinical efficacy,pathology,and gastroscope curative effect,while the eradication of helicobacter pylori efficient is inferior to western medicine.This evaluation needs more high-quality randomized controlled trials to further provide validation support.
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