中西医结合治疗幽门螺杆菌感染相关糜烂性胃炎的Meta分析

A Meta analysis of treating erosive gastritis associated with Helicobacter pylori infection in the integrative medicine

目的:评价中医药治疗幽门螺杆菌感染(Helicobacter pylori,Hp)相关的糜烂性胃炎的临床疗效。方法:全面检索2000年1月-2018年3月国内的相关数据库,包括中国知网、万方数据库、维普中文科技期刊数据库和中国生物医学文献数据库,并依据Jadad量表评价标准对纳入文献进行质量评价,对检索到的符合条件的14篇文献、共1210例患者采用Rev Man 5.3软件进行Meta分析。结果:总有效率方面:共有12篇文献进行总有效率的研究,异质性检验提示无明显异质性(P=0.96,I2=0),采用固定效应模型;合并分析后提示治疗组与对照组差异具有显著性[OR=5.23(95%CI:3.52~7.78),Z=8.19,P<0.00001],表明中医药治疗组总有效率优于对照组。漏斗图提示存在一定偏倚。Hp转阴率情况:共有12个研究进行Hp转阴率的研究,异质性检验提示所纳入研究无明显异质性(P=0.94,I2=0),采用固定效应模型;合并分析后提示治疗组与对照组具有显著性差异[OR=3.07(95%CI:2.14~4.39),Z=6.11,P<0.00001]。表明中西医联合治疗组Hp转阴率优于对照组。漏斗图提示偏倚较小。结论:中西医结合治疗Hp相关性糜烂性胃炎可提高临床疗效,并有效提高Hp转阴率,但仍需后续高质量的研究进一步支持。

Objective:To evaluate the efficacy of the integrative medicine on erosive gastritis associated with Hp infection.Methods:From January 2000 to March 2018,relevant domestic databases were comprehensively searched,including CNKI,Wanfang Database,Weipu Chinese Science and Technology Periodical Database and China Biomedical Literature Database.The included literature was evaluated for quality,according to the Jadad scale evaluation criteria.1210 patients with 14 eligible articles were subjected to meta-analysis by RevMan 5.3 software.Results:Total clinicalefficiency:heterogeneity analysis was performed in 12 documents which carried out related research,suggesting that there was no statistical heterogeneity(P=0.96,I2=0),hence the fixed-effects model was applied.There was statistical difference between the treatment group and the control group[OR=5.23(95%CI:3.52~7.78),Z=8.19,P﹤0.00001].The forest plot was indicated that the publication bias was existed.Hp negative rate:there were 11 literature relating to Hp negative,which turned out to be no statistical heterogeneity.Then it applied the fixed-effects model(P=0.94,I2=0),the result showed that there was significant difference between experimental and control groups[OR=3.07(95%CI:2.14~4.39),Z=6.11,P﹤0.00001].The forest plot indicated that the statistical heterogeneity was relatively low.Conclusion:Combination of Traditional Chinese medicine and Western medicine may be effective in treating erosive gastritis with Hp(+),and improve the rate of Hp negative conversion,but more RCTs with high quality are needed to prove this standpoint.