四逆散合左金丸治疗胃食管反流病的Meta分析

Meta-analysis on Gastroesophageal Reflux Treated with Sini Power(四逆散)and Zuojin Pill(左金丸)

目的:系统评价四逆散合左金丸治疗胃食管反流病的临床疗效。方法:计算机检索维普数据库(VIP)、中国知网(CNKI)、万方数据库、Pubmed、Embase、Cochrane,纳入以四逆散合左金丸治疗胃食管反流病的随机对照临床试验,检索时限均从建库至2019年7月27日,用改良Jadad质量评价表对纳入研究的文献方法学质量进行评价,用RevMan5.3软件进行分析。结果:共纳入13篇文献,合计936例患者,Meta分析结果显示,与单纯西药组比较,四逆散合左金丸或联合西药治疗胃食管反流病在总有效率[OR=2.90,95%CI(1.82,4.63),P<0.000,01]、复发率[OR=0.18,95%CI(-0.09,0.38),P<0.000,01]方面具有一定的优势,差异均有统计学意义,而胃镜积分变化方面,差异无统计学意义[WMD=0.06,95%CI(-0.32,0.44),P=0.75]。四逆散合左金丸联合西药在临床症状积分改善方面具有一定的优势,差异有统计学意义[WMD=4.20,95%CI(2.04,6.36),P=0.000,1]。结论:四逆散合左金丸或联合西药治疗胃食管反流病在总有效率、复发率方面优于单纯西药,胃镜改善方面与单用西药相当。四逆散合左金丸联合西药治疗胃食管反流病在改善临床症状方面优于单用西药。但由于纳入研究文献数量及质量有限,上述结论仍需开展大样本、高质量、多中心、双盲的随机对照试验研究进一步验证。

Objective: To review systematically the curative efficacy of Sini Power and Zuojin Pill on gastroesophageal reflux. Methods: The literature were retrieved from VIP, CNKI, Wanfang databases, PubMed, Embase and Cochrane. The randomized controlled clinical trials on gastroesophageal reflux treated with Sini Power and Zuojin Pill were retrieved from database creation to July 27, 2019. The quality of the included literature methodology was evaluated by the modified Jadad quality table. Statistical analysis were performed by RevMan5.3 software. Results: Totally 13 papers were included, involving 936 patients. The Meta-analysis results showed that comparing with the simple western medicine group, Sini Powder and Zuojin Pill had certain advantages in total effective rate [OR=2.90, 95% CI(1.82, 4.63), P<0.000,01] and recurrence rate [OR=0.18, 95% CI(-0.09, 0.38),P<0.000,01] in the treatment of gastroesophageal reflux, and the differences were statistically significant. While the gastroscopy scores changes had no statistical significance [WMD=0.06, 95% CI(-0.32, 0.44), P=0.75]. Sini Powder and Zuojin Pill had certain advantages in improving the clinical symptom scores for gastroesophageal reflux[WMD=4.20, 95% CI(2.04, 6.36), P=0.000,1]. Conclusion: The present literature study indicates that compared with those of simple western medicine group, Sini Power and Zuojin Pill or combined with western medicine is more advantageous at the the total effective rate and recurrence rate for gastroesophageal reflux. While the improvement of gastroscopy is comparability. Sini Power and Zuojin Pill combined with western medicine is more advantageous at the the clinical symptom for gastroesophageal reflux. However, due to the limitation of the quantity and quality of the included literatures, the above conclusions still need to be further verified by large sample,high-quality, multi-center, double-blind randomized controlled trial studies.