半夏泻心汤加减治疗小儿幽门螺杆菌相关性胃病的疗效评价

Efficacy Evaluation of Banxia Xiexin Decoction in the Treatment of Helicobacter Pylori-Associated Gastric Diseases in Children

目的系统评价半夏泻心汤加减治疗小儿幽门螺杆菌相关性胃病的有效性和安全性。方法计算机检索Cochrane Library、PubMed、中国知网、维普、万方、中国生物医学数据库,检索时间为建库至2019年4月。按照纳入、排除标准选择文献、提取资料和进行质量评价后,采用RevMan 5.3.5软件进行Meta分析。结果本研究共纳入7个随机对照试验,共计684例,试验组为半夏泻心汤加减联合西药,对照组单用西药治疗。纳入文献均以临床症状改善、Hp根除率、不良反应等作为评价指标;Meta分析显示:半夏泻心汤联合西药治疗小儿Hp相关性胃病在临床疗效及安全性方面优于单用西药,差异有统计学意义[OR=4.75,95%CI(2.36,9.55),P<0.0001]、[OR=2.80,95%CI(1.90,4.13),P<0.00001],与对照组相比,半夏泻心汤联合西药可提高患儿Hp根除率[OR=2.21,95%CI(1.04,4.72),P=0.04]。结论与单用西药相比,联合口服半夏泻心汤加减能缓解患儿腹痛(胀)、恶心、呕吐等消化道症状,提高临床疗效;且该方有一定的抑杀Hp的作用,联合使用能在一定程度上提高Hp的根除率,但与成人中西药联合治疗,既可增强西药对Hp的根除率,又能减少西药的毒副作用和耐药性,且能提高患者治疗的依从性的结论有一定的出入。

Objective To systematically review the effectivess and safety of Banxia Xiexin Decoction in the treatment of Helicobacter pylori-associated gastric diseases in children.Methods The Cochrane Library,PubMed,CNKI,VIP,WanFang Data,and CBM databases were searched by computer.The search time was built until April 2019.Metaanalysis was performed using RevMan 5.3.5 software after selecting literature,extracting data,and performing quality evaluation according to the inclusion exclusion criteria.Results This study involves 7 randomized controlled trials,with a total of 684 patients.The experimental group was treated with Banxia Xiexin Decoction plus Western medicine,and the control group was treated with western medicine alone.The inclusion of the literature was based on clinical symptoms improvement,Hp eradication rate,adverse reactions,etc.;Meta-analysis showed that:Banxia Xiexin Decoction combined with Western medicine in the treatment of children with Hp infection-related gastric disease is superior to Western medicine alone in clinical efficacy and safety.The difference was statistically significant[OR=4.75,95%CI(2.36,9.55),P<0.0001],[OR=2.80,95%CI(1.90,4.13),P<0.00001],compared with the control group,Banxia Xie Xin Decoction combined with western medicine can improve Hp eradication rate in children[OR=2.21,95%CI(1.04,4.72),P=0.04].Conclusion Compared with western medicine alone,combined oral Banxia Xiexin Decoction can alleviate gastrointestinal symptoms such as abdominal pain(bloating),nausea and vomiting,and improve clinical efficacy;and this side has certain effect of inhibiting Hp.Combined treatment can improve the eradication rate of Hp to a certain extent.However,the conclusion that combined with adult Chinese and Western medicine can not only enhance the eradication rate of western medicine against Hp,but also reduce the side effects and drug resistance of western medicine and improve the compliance of patients is somewhat different.