乌贝散加味联合西药治疗HP相关性消化性溃疡的Meta分析

Meta Analysis of Modified Wubei Powder Combined with Western Medicine in the Treatment of Helicobacter Pylori Associated Peptic Ulcer

目的:对乌贝散加味联合西药治疗HP相关性消化性溃疡的Meta分析。方法:全面检索中国知网数据库(CNKI)、中文科技期刊数据库(维普)、万方知识数据服务系统、中国中医药数据库服务系统、PubMed系统。检索时间至2019年12月。筛选出乌贝散加味联合西药治疗HP相关性消化性溃疡的随机对照试验(Randomized controlled trials,RCTs),对符合纳入标准的文献进行数据提取,并根据Cochrane协作网推荐的偏倚风险评估工具对纳入文献进行质量评价,采用RevMan 5.3统计软件进行数据分析。结果:共纳入33项研究,病例总数(3201)例,试验组(观察组)(1614)例,对照组(1587)例。Meta分析结果提示:试验组溃疡愈合率(OR=4.60,95%CI[3.64,5.80],P<0.00001)、HP根除率(OR=3.47,95%CI[2.32,5.19],P<0.00001),不良反应发生率(OR=0.33,95%CI[0.20,0.53],P<0.00001),溃疡复发率(OR=0.25,95%CI[0.18,0.34],P<0.00001),均显著优于对照组,差异有统计学意义。有7项研究报告了不良反应,不良反应主要以头痛、头晕、皮疹、胃肠道反应为主,不影响治疗效果。结论:乌贝散加味联合西药治疗HP阳性消化性溃疡疗效好,优于单纯西药治疗,可减少不良反应的发生率,但在治疗过程中需注意不良反应,同时需要更多大样本、多中心、更严谨、高质量的随机对照试验评估中药临床应用中的疗效和安全性,以提高文献的科学性、可信性,为临床实践提供有力的循证医学证据。

Objective:Meta analysis of modified Wubei powder combined with western medicine in the treatment of helicobacter pylori associated peptic ulcer.Methods:Search was performed throughout China National Knowledge Infrastructure(CNKI),VIP,WanFang,China’s traditional Chinese medicine,PubMed database up to December 2019.Randomized controlled trials of Wubei powder combined with western medicine in the treatment of helicobacter pylori associated peptic ulcer were retrieved,clinical studies matched the inclusion criteria were involved to conduct data extraction,the quality of the included literature evaluated by the risk bias assessment tools in the Cochrane review manual and meta-analysis using RevMan 5.3.Results:A total of 33 studies were involved,including 3201 patients,divided into 1614 in experimental group(observation group)and 1587 in control group.Results of meta-analysis showed:the experimental group ulcer healing rate(OR=4.60,95%CI[3.64,5.80],P<0.00001),HP eradicate rate(OR=3.47,95%CI[2.32,5.19],P<0.00001),incidence of adverse reactions(OR=0.33,95%CI[0.20,0.53],P<0.00001),ulcer recurrence rate(OR=0.25,95%CI[0.18,0.34],P<0.00001),were significantly better than the control group,the difference was statistically significant.Seven studies reported adverse reactions,adverse reactions mainly headache,dizziness,skin rash,gastrointestinal reaction is given priority to,does not affect the treatment effect.Conclusions:Modified Wubei powder combined with western medicine in the treatment of helicobacter pylori associated peptic ulcer the curative effect and safety is good,is better than pure western medicine treatment,can reduce the incidence of adverse reactions,but need to pay attention to the adverse reactions in the treatment process,and need more large sample,multicenter,more rigorous,high quality randomized controlled trial to assess efficacy and safety of clinical application of Chinese medicine,in order to improve the scientific literature,credibility,provide strong evidence of evidence-based medicine for clinical practice.