口服中药复方治疗溃疡性结肠炎临床疗效Meta分析

Meta-analysis of the efficacy of oral traditional Chinese medicine in the treatment of ulcerative colitis

[目的]系统评价口服中药复方治疗溃疡性结肠炎(UC)的随机对照试验的临床疗效及安全性。[方法]2位研究者独立地系统检索口服中药复方治疗UC的全部临床随机对照试验(RCT)的中英文文献。数据库包括:中国生物医学文献数据库(CBM)、中国知网知识发现网络平台(CNKI)、重庆维普科技数据库(VIP)和万方数据知识数据库(Wanfang Datebase)、PubMed,检索时间均从建库至2018年6月。2位研究者独立提取资料,如遇分歧,请求第三方协助解决。同时使用Review Manager 5.3软件进行本研究的数据处理。[结果]最终共纳入20篇文献,共计1 703例UC患者。口服中药复方治疗UC的临床总有效率优于对照组(I2=10%,RR=1.17,95%CI=[1.11,1.21],P<0.00001);口服中药复方改善UC的Sutherland病变活动指数优于对照组(I2=58%,MD=-1.72,95%CI=[-1.92,-1.51],P<0.00001);口服中药复方改善中医证候积分优于对照组(I2=60%,MD=-2.42,95%CI=[-2.90,-1.95],P<0.00001);口服中药复方不良反应发生率与对照组比较差异无统计学意义(I2=33%,RR=0.56,95%CI=[0.29,1.07],P=0.08)。[结论]口服中药复方治疗UC相较口服氨基水杨酸类药物的疗效更佳且安全性相当。

[Objective]To systematically evaluate the efficacy and safety of the randomized controlled trial of oral Chinese medicine for the treatment of ulcerative colitis(UC).[Methods]The Chinese and English literatures of all clinical randomized controlled trials(RCT)on the treatment of UC by oral traditional Chinese medicine compound prescription were searched independently and systematically by two individuals.The database includes:China biomedical literature database(CBM),China national knowledge infrastructure(CNKI),VIP Database for Chinese Technical Periodicals(VIP),Wan Fang Database and PubMed Database.The retrieval time is from the database construction to June 2018.The two researchers independently extracted the data.In case of disagreement,they asked the other one to help solve the problem.Meanwhile,Review Manager 5.3 software was used to process the data of this study.[Results]A total of 20 literatures were included,including 1703 patients with UC.The curative effect of the experimen-tal group was superior to the control group(I^2=10%,RR=1.17,95%CI=[1.11,1.21],P<0.00001).The improvement of Sutherland activity index of UC by oral Chinese medicine was better than the control group(I^2=58%,MD=-1.72,95%CI=[-1.92,-1.51],P<0.00001).The score of improved TCM syndrome was better than the control group(I^2=60%,MD=-2.42,95%CI=[-2.90,-1.95],P<0.00001).There was no significant difference between the rates of adverse reaction of the experimental group and the control group(I^2=33%,RR=0.56,95%CI=[0.29,1.07],P=0.08).[Conclusion]Oral traditional Chinese medicine for treatment of UC is safe and more effective than oral medicine of amino salicylic acid.