枳实消痞汤治疗糖尿病胃轻瘫Meta分析

Meta-analysis of Zhishi Xiaopi Decoction in Treating Diabetic Gastroparesis

目的：评价枳实消痞汤治疗糖尿病胃轻瘫（DGP）的临床疗效。方法：计算机检索维普数据库（VIP）、万方数据库、中国期刊全文数据库（CNKI）、中国医院知识总库（CHKD）及Pubmed,纳入有关枳实消痞汤治疗糖尿病胃轻瘫的临床随机对照（RCTs）研究,按照RCT质量评价修改后Jadad量表评价标准对纳入文献进行质量评价,使用Review Manger 5.3软件进行Meta分析统计学处理。结果：共纳入13个RCT研究,包括1120例患者。Meta分析结果显示,枳实消痞汤治疗DGP能提高临床总有效率（Z=8.29,P〈0.00001,OR=4.75,95%CI=3.29-6.87）;提高治愈率（Z=4.53,P〈0.00001,OR=2.41,95%CI=1.45-3.52）;增加胃排空率（Z=11.7,P〈0.00001,OR=18.46,95%CI=15.37-21.55）;降低临床症状积分（Z=4.55,P〈0.00001,OR=-21.32,95%CI=-30.50--12.13）。结论：枳实消痞汤治疗DGP能显著提高临床有效率、治愈率、增加胃排空率及降低临床症状积分,相比单纯使用西医治疗方案具有一定优势,但还需大样本、高质量的随机双盲对照试验进一步验证。

Objective：To assess the efficacy of Zhishi Xiaopi Decoction on the treatment of diabetic gastroparesis（DGP）. Methods：According to strict inclusive and exclusive criteria,through electronic searches of relevant randomized controlled trials（RCTs）on Zhishi Xiaopi Decoction for DGP in Pubmed,CHKD,CNKI,Wan Fang Data and VIP Database. All reviewed literatures were assessed via Jadad quality scale. Data statistical analyses were performed by Rev Man 5.3. Results：13 trials involving 1120 patients were included. Meta-analysis showed that compared with the control group,Zhishi Xiaopi Decoction could improve the clinical effective rate（Z=8.29,P〈0.00001,OR=4.75,95%CI=3.29-6.87）;improve the cure rate（Z=4.53,P〈0.00001,OR=2.41,95%CI =1.45-3.52）;increase stomach emptying rate（Z=11.7,P〈0.00001,OR =18.46,95%CI=15.37-21.55）;and degrade clinical symptom score（Z=4.55,P〈0.00001,OR=-21.32,95%CI=-30.50--12.13）. Conclusion：Zhishi Xiaopi Decoction in treating DGP can effectively improve the clinical effective rate and cure rate,increase stomach emptying rate and degrade clinical symptom score,but still need more high quality,double-blind trials with a large sample size to further verify the efficacy.