Banxia Xiexin decoction combined with triple or quadruple therapy in the treatment of Hp-related chronic gastritis:A Meta-analysis
-
摘要: [目的]系统评价半夏泻心汤联合三联或四联疗法治疗幽门螺杆菌(Hp)相关胃炎的疗效和安全性。[方法]应用计算机检索中国知网数据库(CNKI)、中国生物医学文献数据库(SinoMed)、维普数据库(VIP)和万方数据库(WanFang)、PubMed、EMbase、The Cochrane Library,检索时间限定为2015年1月1日~2019年12月20日,收集半夏泻心汤联合三联或四联治疗Hp相关胃炎的随机对照试验,根据Cochrane Handbook 5.3偏倚风险评估方法,采用RevMan 5.3软件进行Meta分析。[结果]纳入14篇随机对照研究,共1 475例患者。相比单纯三联或四联疗法,半夏泻心汤联合三联或四联疗法在临床疗效(总有效率)(RR=1.19,95%CI 1.14~1.25,Z=7.03,P<0.000 01)、Hp根除率(RR=1.17,95%CI 1.12~1.22,Z=6.88,P<0.000 01)、改善胃痛症状(-0.61,95%CI-0.87~-0.35,P<0.000 01)及痞满症状(-0.63,95%CI-0.88~-0.39,P<0.000 01)等方面效果更优,且不良反应发生率更低(RR=0.47,95%CI 0.29~0.75,Z=3.18,P=0.001),差异有统计学意义。[结论]半夏泻心汤联合三联或四联疗法相比较单纯西药三联或四联疗法临床治疗效果较优,且能提高Hp根除率,不良反应较少,但尚需高质量的研究进一步验证。Abstract: [Objective]To evaluate efficacy and safety of Banxia Xiexin decoction combined with triple or quadruple therapy in the treatment of Hp related chronic gastritis.[Methods]Retrieved from CNKI,SinoMed,VIP,WanFang,PubMed,EMbase and The Cochrane Library,RCTs about Banxia Xiexin decoction combined with triple or quadruple therapy in the treatment of Hp related chronic gastritis were collected.The retrieval time is limited from January 1,2015 to December 20,2019.Using Revman 5.3 software for meta-analysis based on the Cochrane Handbook 5.3 risk of bias assessment method.[Results]A total of 14 RCTs were included,including 1475 patients.Compared with western medicine triple or quadruple therapy,Banxia Xiexin decoction combined with triple or quadruple therapy is more effective in clinical efficacy\[RR=1.19,95%CI 1.14~1.25,Z=7.03,P<0.00001\]、Hp eradication rate,\[RR=1.17,95%CI 1.12~1.22,Z=6.88,P<0.00001\]、improvement of stomachache symptoms\[-0.61,95%CI-0.87~-0.35,P<0.00001\] and stomach distension symptoms\[-0.63,95%CI-0.88~-0.39,P<0.00001\].And the incidence of adverse reactions is lower \[RR=0.47,95%CI 0.29~0.75,Z=3.18,P=0.001\].The differences were statistically significant.[Conclusion]Compared with western medicine triple or quadruple therapy,Banxia Xiexin decoction has a better clinical effect and can improve the eradication rate of Hp with fewer adverse reactions.However,high-quality clinical studies are still needed for further verification.
-
Key words:
- Banxia Xiexin decoction /
- helicobacter pylori /
- chronic gastritis /
- systematic review /
- Meta-analysis
-
-
[1] 胡伏莲,张声生.全国中西医整合治疗幽门螺杆菌相关“病-证”共识[J].中国中西医结合消化杂志,2018,26(9):715-723.
[2] Correa P.Human gastric carcinogenesis:A multistep and multifactorial process—First American cancer Society award lecture on cancer epidemiology and prevention[J].Cancer Res,1992,52(24):6735-6740.
[3] 刘文忠,谢勇,陆红,等.第五次全国幽门螺杆菌感染处理共识报告[J].胃肠病学,2017,22(6):346-360.
[4] 刘利新,张可训.半夏泻心汤联合西医治疗慢性胃炎59例[J].现代中医药,2019,39(3):50-52.
[5] 刘建文,崔秀敬,臧玉莉,等.半夏泻心汤加味联合三联疗法根除慢性胃炎患者H pylori感染疗效观察[J].现代中西医结合杂志,2015,24(1):67-69.
[6] 吴拓生.半夏泻心汤联合西药治疗慢性萎缩性胃炎的效果和安全性[J].中外医学研究,2018,16(35):33-35.
[7] 张伟,姜锐,王璐.中药半夏泻心汤治疗慢性胃炎伴幽门螺杆菌感染的疗效及安全性分析[J].辽宁中医杂志,2018,45(7):1424-1426.
[8] 彭海平,保继琼,赵敏,等.加味半夏泻心汤治疗幽门螺杆菌相关性萎缩性胃炎32例[J].西部中医药,2015,28(2):94-96.
[9] 朱耀宇,李红丽.加味半夏泻心汤对调养幽门螺旋杆菌相关性胃炎的临床分析[J].中华中医药学刊,2018,36(7):1764-1766.
[10] 李胜旭.奥美拉唑三联疗法与半夏泻心汤方加减对慢性胃炎患者幽门螺杆菌感染的临床疗效及其对Hp清除的影响[J].抗感染药学,2018,15(11):1995-1997.
[11] 李锋华,甘旗旗.半夏泻心汤加减对幽门螺旋杆菌感染的疗效观察[J].陕西中医,2016,37(8):953-955.
[12] 杨卫远,郑秀金,周俊香,等.半夏泻心汤联合三联疗法治疗慢性胃炎合并幽门螺杆菌感染55例[J].福建中医药,2019,50(4):9-11.
[13] 林裕强,陈海霞,孙晓敏.半夏泻心汤联合含铋剂四联疗法治疗慢性胃炎合并幽门螺杆菌感染的疗效评价[J]现代消化及介入诊疗,2015,20(2):110-112.
[14] 王文文.加味半夏泻心汤联合三联疗法治疗幽门螺杆菌相关性萎缩性胃炎疗效观察[J].现代中西医结合杂志,2018,27(28):3153-3155.
[15] 王海英.半夏泻心汤联合含铋剂四联疗法治疗慢性胃炎合并幽门螺杆菌感染的疗效评价[J].现代中西医结合杂志,2019,28(7):773-775.
[16] 耿艳,皇甫沁媛,范利锋,等.半夏泻心汤联合含铋剂四联疗法治疗慢性胃炎合并幽门螺杆菌感染的疗效评价[J].现代中西医结合杂志,2019,28(22):2478-2481.
[17] 黄停停,崔倩倩,赵文霞.改良半夏泻心汤治疗Hp相关性胃炎176例[J].光明中医,2018,33(11):1556-1558.
[18] 黄彦平,詹达法,黄海等.半夏泻心汤人含药血清对HP感染GES1细胞TGF-β/Smad信号通路的影响[J].中国实验方剂学杂志,2018,24(14):91-96.
[19] 陈玲.半夏泻心汤加味对慢性胃炎症状体征改善情况、血清炎症因子变化及临床治疗效果分析[J].中华中医药刊,2019,37(7):1763-1766.
[20] 于丹丹,谢雁鸣,廖星,等.《中国中药杂志》发表随机对照试验方法学和报告质量评价研究[J].中国中药杂志,2018,43(4):833.
-
计量
- 文章访问数: 70
- PDF下载数: 1002
- 施引文献: 0
下载: