中医药治疗溃疡性结肠炎患者肠道菌群变化的Meta分析

Meta Analysis of Intestinal Flora Changes in Patients with Ulcerative Colitis Treated by Traditional Chinese Medicine

目的系统评价中西医对比治疗溃疡性结肠炎(ulcerative colitis,UC)患者肠道菌群的变化。方法通过检索CNKI、WANFANG、VIP、CBM、Pub Med、Cochrane Library数据库获得文献,将最终纳入的文献采用Rev Man5.3软件进行Meta分析。结果共纳入符合纳入标准的文献21篇,全部为随机对照临床试验研究。Meta分析结果表明,中医药治疗溃疡性结肠炎在临床总有效率、治愈率、肠道菌群改善等方面优于西药对照组,其中,中医药治疗UC患者的乳酸杆菌水平优于西药治疗(SMD=0.72,95%CI[0.58,0.87],P<0.00001);双歧杆菌水平显著高于西药治疗(SMD=1.45,95%CI[1.00,1.90],P<0.00001);大肠杆菌水平较西药组低(SMD=-1.88,95%CI[-2.77,-0.99],P<0.00001);肠球菌水平低于西药组(SMD=-1.57,95%CI[-2.76,-0.38],P<0.00001)。结论中医药治疗后溃疡性结肠炎患者的肠道益生菌增多,条件致病菌减少。因此,在临床实践中可以通过中医药治疗来改善肠道菌群紊乱,提高UC临床治愈率。

Objective To systematically evaluate the changes of intestinal flora in patients with ulcerative colitis(UC)in the comparative treatment of traditional Chinese and Western medicine.Methods Literature was retrieved from databases of CNKI,WANFANG,VIP,CBM,Pub Med and Cochrane Library,and the final included literature was Meta analyzed with Rev Man5.3 software.Results A total of 21 qualified literatures were included,all of which were randomized controlled clinical trials.The results of Meta-analysis showed that the treatment of ulcerative colitis with Traditional Chinese Medicine was superior to the western control group in terms of total clinical efficiency,cure rate and intestinal flora improvement.Among them,the lactobacillus level of UC patients treated with Traditional Chinese Medicine was superior to that of western medicine(SMD=0.72,95%CI[0.58,0.87],P<0.00001).The level of bifidobacterium was significantly higher than that of western medicine(SMD=1.45,95%CI[1.00,1.90],P<0.00001).The content of escherichia coli was less than that of western medicine group(SMD=-1.88,95%CI[-2.77,-0.99],P<0.00001).The level of enterococcus was lower than that of western medicine group(SMD=-1.57,95%CI[-2.76,-0.38],P<0.00001).Conclusion The probiotics in patients with UC treated by Traditional Chinese Medicine increased,and the opportunistic pathogens decreased.Therefore,in clinical practice,TCM treatment can be used to improve intestinal flora disorders and improve the clinical cure rate of UC.