香砂养胃丸治疗慢性胃炎的疗效与安全性的系统评价与Meta分析

Systematic review and Meta-analysis of efficacy and safety of Xiangsha Yangwei Pills in treatment of chronic gastritis

为系统评价香砂养胃丸治疗慢性胃炎的疗效与安全性,采用计算机检索Cochrane图书馆、Medline、EMbase、中国知网数据库(CNKI)、中国生物医学文献服务系统(SinoMed)、重庆维普中文科技期刊数据库(VIP)和万方数据库(WanFang),检索香砂养胃丸联合西药治疗慢性胃炎的随机对照试验,检索时限均从建库至2019年4月26日。由2名研究者按照纳入与排除标准独立进行文献筛选、资料提取和质量评价后,采用RevMan 5.3软件进行Meta分析。共纳入18个RCT,总计1720例患者。按照慢性胃炎分类分为3个亚组:慢性胃炎、慢性萎缩性胃炎、慢性浅表性胃炎。Mete分析结果显示,香砂养胃丸联合西药治疗慢性胃炎的有效率高于西药常规治疗。在复发率上,香砂养胃丸单独使用或联合常规西药的复发率均低于单独使用常规西药。在幽门螺杆菌(Hp)根除率上,香砂养胃丸联合常规西药与单独使用常规西药相比无统计学差异。在不良反应方面,香砂养胃丸联合西药的不良反应少于西药常规治疗,且尚未见严重的不良反应报告。该系统评价结果显示,与常规西药治疗组相比,香砂养胃丸联合西药可明显改善慢性胃炎的临床症状,并且不良反应少。但由于纳入研究的方法学质量普遍较低,影响结论的可靠性,尚需要高质量的多中心、大样本、随机双盲对照试验进行验证。

To systematically evaluate the efficacy and safety of Xiangsha Yangwei Pills in the treatment of chronic gastritis.Compu-ter retrieval was performed for Cochrane Library,Medline,EMbase,China Knowledge Network Database(CNKI),China Biomedical Literature Service System(SinoMed),Chongqing Weipu Chinese Science and Technology Journal Database(VIP)and WanFang Database(WanFang)randomized controlled trials about Xiangsha Yangwei Pills combined with Western medicine in the treatment of chro-nic gastritis.The retrieval time ranged from the establishment of the library to April 26,2019.Meta-analysis was performed by RevMan 5.3 software after two independent researchers conducted literature screening,data extraction and quality evaluation according to inclusion and exclusion criteria.A total of 1720 patients were enrolled in 18 RCT.According to the classification of chronic gastritis,they were divided into three subgroups:chronic gastritis,chronic atrophic gastritis and chronic superficial gastritis.The results of Meta-ana-lysis showed that the efficacy of Xiangsha Yangwei Pills combined with Western medicine in treating chronic gastritis was higher than that of Western medicine.As for the recurrence rate,Xiangsha Yangwei Pills combined with Western medicine was lower than Western medicine.And there was no statistical difference about helicobacter pylori(Hp)eradication rate between Xiangsha Yangwei Pills combined with Western medicine as well as Western medicine.In terms of the incidence of adverse reactions,Xiangsha Yangwei Pills combined with Western medicine was lower than Western medicine,and no serious adverse reaction was reported.The results of this systematic review showed that compared with the conventional Western medicine group,Xiangsha Yangwei Pills combined with Western medicine can significantly alleviate clinical symptoms of chronic gastritis,with fewer adverse reactions.However,due to the low methodological quality of the included studies and the reliability of the impact conclusions,high-quality multi-center,large-sample,randomized,double-blind controlled trials are needed for validation.