健脾益气和胃中药治疗糖尿病胃轻瘫的系统评价

Chinese Medicine Prescription of Jianpi Yiqi Hewei for the Treatment of Diabetic Gastroparesis: A Meta-analysis

目的系统评价健脾益气和胃中药治疗糖尿病胃轻瘫的临床疗效和安全性。方法检索Pub Med、MEDLINE、The Cochrane Library、Embase、CBM、CNKI、VIP及万方等数据库,纳入符合条件的临床随机对照试验。按照Cochrane系统评价标准对纳入文献进行质量评价,应用Rev Man 5.3软件进行Meta分析。结果共纳入28个研究,2 370例患者。Meta分析结果显示,健脾益气和胃中药治疗糖尿病胃轻瘫的总有效率[RR=1.29,95%CI(1.24~1.35),P<0.000 01]、对腹胀[MD=-0.31,95%CI(-0.42,-0.21),P<0.000 01]、纳差[MD=-0.45,95%CI(-0.72,-0.18),P=0.001]、嗳气[MD=-0.32,95%CI(-0.53,-0.10),P=0.004]等临床症状的改善均优于西药。中药治疗组不良反应[RD=-0.03,95%CI(-0.06,-0.00),P=0.03]及复发率[RR=0.25,95%CI(0.14,0.43),P<0.000 1]均少于西药组。结论健脾益气和胃中药能够有效治疗糖尿病胃轻瘫,但仍需大规模、高质量的临床随机对照研究加以验证。

OBJECTIVE To systematically evaluate the clinical efficacy and safety of Chinese medicine prescription of Jianpi Yiqi Hewei for the treatment of diabetic gastroparesis（DGP）. METHODS Pub Med, MEDLINE, The Cochrane Library, Embase, CBM, CNKI, VIP and Wanfang Data bases were searched and eligible randomized controlled trials（RCTs） were included. According to the evaluation standard of Cochrane system, the quality of literature was evaluated and meta-analysis was conducted by Rev Man 5.3 software. RESULTS Twenty-eight RCTs involving 2 370 patients were identified. Meta-analysis showed that the effects of Chinese medicine group were superior to the western medicine group [RR=1.29, 95%CI（1.24, 1.35）, P0.000 01] and in improving symptoms of abdominal distention [MD=-0.31, 95%CI（-0.42,-0.21）, P〈0.000 01], anorexia [MD=-0.45, 95%CI（-0.72,-0.18）, P=0.001] and belching [MD=-0.32, 95%CI（-0.53,-0.10）, P=0.004], the Chinese medicine group was much better than the control group. The adverse reactions [RD=-0.03, 95%CI（-0.06,-0.00）, P=0.03] and recurrence rate [RR=0.25, 95%CI（0.14, 0.43）, P〈0.000 1] of Chinese medicine group were less than western medicine group. CONCLUSION The curative effect of Chinese medicine prescription on treatment of diabetic gastroparesis is superior to western medicine. However, it is still necessary to be verified by large-scale, high-quality randomized controlled trials.