中医外治法治疗胃食管反流病的Meta分析

Gastroesophageal Reflux Disease Treated with the External Treatment of TCM: A Meta-Analysis

目的系统评价中医外治法对胃食管反流病的临床疗效及安全性。方法计算机检索Web of Since,Pub Med,中国知网,万方数据库和中国生物医学文献数据库,收集中医外治法(或联合内服药物)治疗胃食管反流病的随机、半随机对照试验,用Revman5.20软件对结果进行Meta分析。结果共纳入文献30篇,3706例患者。Meta分析结果显示外治法(或联合内服药物)在总有效率(RR=1.15,95%CI 1.12~1.18)、镜下有效率(RR=1.15,95%CI 1.14~1.37)及复发率(RR=0.39,95%CI 0.30~0.52)方面优于内服药物,且可显著降低症状积分、反流性疾病问卷(Reflux disease questionnaire,RDQ)积分,改善血清胃泌素水平。结论中医外治法是治疗胃食管反流病的有效手段,但仍需更严谨设计的临床试验以进一步验证。

Objective To review systematically the clinical therapeutic effects and safety of gastroesophageal reflux disease（ GERD） treated with the external method of TCM. Methods Through the Webe of Since,Pub Med,CNKI,Wanfang Data and CBM,the randomized controlled trials（ RCTs） or semi-RCTs of GERD treated with TCM external therapy（ or combined with medication） were collected. With Revman 5. 20 software,the Mata-analysis on the data were conducted. Results A total of 30 papers were collected,including 3706 patients. With Meta-analysis,the results showed that the overall effective rate of the external therapy（ or combined with medicine）（ RR = 1. 15,95% CI 1. 12 to 1. 18）,the under-microscopic effective rate（ RR = 1. 15,95% CI 1. 14 to 1. 37） and the recurrence rate（ RR = 0. 39,95% CI 0. 30 to 0. 52） were all superior to the medication. This treatment reduced significantly the symptom scores,the scores of reflux disease questionnaire and improves serum gastrin. Conclusion The external therapy of TCM is the effective approach to GERD. But,a more rigorous design of clinical trial is required for a further verification.