柴胡疏肝散合左金丸加减治疗慢性糜烂性胃炎的系统评价

Systematic Review on Chaihu Shugan Power Combined with Zuojin Pills in the Treatment of Chronic Erosive Gastritis

目的:系统评价柴胡疏肝散合左金丸加减治疗慢性糜烂性胃炎的疗效与安全性.方法:计算机检索维普资讯中文科技期刊数据库、中国期刊全文数据库、万方数据库、PubMed、EMBase及the Cochrane Library等,搜集柴胡疏肝散合左金丸加减治疗慢性糜烂性胃炎的随机对照研究(观察组患者采用柴胡疏肝散合左金丸加减治疗,对照组患者采用常规西药"三联"或"四联"治疗),检索时限为建库至2019年6月.由2名研究者独立筛选文献、提取资料并评价文献质量;根据Cochrane系统评价方法,采用RevMan 5.3软件进行文献荟萃分析(Meta分析).结果:共纳入13篇文献,涉及1303例患者.Meta分析结果显示,治疗后,观察组患者的有效率明显高于对照组,单核细胞浸润程度和中性粒细胞浸润程度、不良反应发生率和复发率均明显低于对照组,差异均有统计学意义(P<0.05).结论:与常规西药治疗比较,柴胡疏肝散合左金丸加减治疗慢性糜烂性胃炎,可在一定程度上提高治疗有效率,并可降低患者单核细胞浸润程度和中性粒细胞浸润程度,还能在一定程度上缓解不良反应的发生和降低复发率.但纳入研究有限,尚需要更多更高质量的多中心、大样本、前瞻性的随机、双盲临床试验验证.

OBJECTIVE:To systematically evaluate the efficacy and safety of Chaihu Shugan power combined with Zuojin pills in the treatment of chronic erosive gastritis.METHODS:VIP database,CNKI,Wanfang database,PubMed,EMBase and the Cochrane Librar were retrieved to collect the randomized controlled trials of Chaihu Shugan power combined with Zuojin pills in the treatment of chronic erosive gastritis(the observation group was treated with Chaihu Shugan power combined with Zuojin pills,while the control group received conventional western medicine“triple”or“quadruple”treatment).The search period was from the establishment of the database to Jun.2019.After two reviewers separately screened literature,extracted data and assessed the quality of the included studies,all data were analyzed with RevMan 5.3 software by Cochrane.RESULTS:A total of 13 articles were collected,including 1303 patients.Meta analysis results showed that the effective rate of the observation group was significantly higher than that of the control group,the degree of monocyte infiltration and neutrophil infiltration,the incidence of adverse drug reactions,and the recurrence rate were significantly lower than those in the control group(P<0.05).CONCLUSIONS:Compared with routine western medicine,Chaihu Shugan power combined with Zuojin Pills in the treatment of chronic erosive gastritis can significant improve the total effect rate and reduce the monocyte infiltration,neutrophils infiltration,decrease the incidence of adverse drug reactions and recurrence rate.However,due to the limitations of the included literature,the above conclusions need to be verified by more high-quality,multi-center,large-sample,prospective,randomized,double-blind clinical trials.