附子理中汤治疗溃疡性结肠炎效果的Meta分析

Meta-analysis of Efficacy of Fuzi Lizhong Decoction in Treatment of Ulcerative Colitis

目的系统评价附子理中汤加减治疗溃疡性结肠炎(UC)的有效性与安全性。方法计算机检索PubMed,The Cochrane Library,Embase,Web of Knowledge,Allied and Complementary Madicine,OpenGrey,CBM,Wanfang Data,VIP和CNKI数据库,查找附子理中汤加减为干预措施治疗UC的随机对照试验,检索时限均从建库至2018年05月15日。收集纳入研究的总有效率、腹泻、脓血便的症状改善、结肠内镜积分和不良反应,进行Meta分析。结果共纳入8个研究,共计730例患者。Meta分析示,对比单用西药,附子理中汤加减联用西药和单用附子理中汤加减疗效的合并RR值分别为1.20[95% CI(1.08,1.32)],1.22[95% CI(1.12,1.33)],存在统计学意义(P<0.05),且单用附子理中汤加减能降低不良反应发生率。敏感性分析和漏斗图分析显示纳入的文献同质性较强,不存在发表偏倚。结论对比单用西药,单用附子理中汤加减与附子理中汤加减联合西药治疗溃疡性结肠炎有更好的临床疗效。单用附子理中汤加减治疗溃疡性结肠炎疗效在总有效率与降低不良反应方面优于西药治疗,但由于纳入文献数目较少,纳入文献的质量不高,需要高质量的大样本双盲随机对照试验的支持。

Objective To discuss the effectiveness and safety of Fuzi Lizhong decoction in the treatment of ulcerative colitis. Methods Databases such as PubMed, The Cochrane Library, Embase, Web of Knowledge, Allied and Complementary Madicine, OpenGrey, CBM, Wanfang Data, VIP and CNKI were searched for the randomized controlled trials(RCT)about Fuzi Lizhong decoction combined with western medicines and western medicine in treating ulcerative colitis from database creation to May 15th, 2018. Their qualities were assessed by the Cochrane scale. The therapies, sample size, clinical efficacy, endoscopic improvement and adverse events of the included literatures were collected. A Meta-analysis was made on the efficacy and adverse events. Results A total of 8 studies involving 730 patients were included. The results of Meta-analysis showed that, compared with western medicines, Fuzi Lizhong decoction and Fuzi Lizhong decoction combined with western medicines the combined RR of the effective rate of 1.20[95% CI(1.08, 1.32)], 1.22[95% CI(1.12, 1.33)], with statistical significance(P<0.05), and significantly reduce the incidence of adverse reactions. The sensitivity analysis and funnel plot analysis showed a higher homogeneity in the literatures and no evidence of publication bias. Conclusion Compared with western medicines, Fuzi Lizhong decoction and Fuzi Lizhong decoction combined with western medicines is batter than western medicines in terms of curative rate and adverse reactions. But it still needs more large-sample-size double-blind RCTs shall be included to support this conclusion.