基于PubMed和Web of Science数据库对中医药治疗慢性萎缩性胃炎现状的文献分析

Literature Study on Current Status of Traditional Chinese Medicine for Chronic Atrophic Gastritis Based on PubMed and Web of Science Databases

目的:梳理和总结中医药治疗慢性萎缩性胃炎(CAG)的研究现状,为相关研究提供一定借鉴和指导,也为进一步了解中医药及应用中医药治疗CAG提供科学证据。方法:检索PubMed和Web of Science数据库自建库至2020年8月31日收录的有关中医药治疗CAG的相关文献,根据纳入与排除标准,对文献进行筛选,纳入符合条件的临床随机对照试验和动物实验,并对纳入研究进行信息提取、归纳和整理。结果:该研究共纳入中医药治疗CAG的临床随机对照试验4篇,动物实验21篇,包含复方研究13篇,单味药研究3篇,以及中药单体研究5篇。临床随机对照试验表明中医药在改善患者胃黏膜病理状态、临床症状等方面作用良好。但存在研究质量参差不齐、胃黏膜病理诊断标准及临床有效率评价标准不统一的问题。动物实验主要以药物作用机制研究为主,其研究结果表明了中医药治疗CAG具有多靶点的作用特点。但CAG动物模型制备、阳性药选择、药物干预方式和干预周期在不同实验中缺乏一致性,是动物实验研究中存在的问题。结论:中医药治疗CAG的疗效逐渐获得全球认可,但在研究方法方面仍需进一步规范及统一。今后还需高质量的临床试验及规范的动物实验,对中药干预CAG的恶性进展时机、有效成分及作用机制等进行深入研究,为充分认识和发挥中医药治疗CAG贡献力量。

Objective:To review and summarize the current research status of traditional Chinese medicine(TCM)for the treatment of chronic atrophic gastritis(CAG),provide references and hints for relevant studies,and contribute to the further understanding of TCM and the application of TCM in the treatment of CAG with scientific evidence.Method:The PubMed and Web of Science databases were searched for relevant literature on the treatment of CAG with TCM from their establishment to August 31,2020.Eligible randomized controlled trials(RCTs)and animal studies were included according to the inclusion and exclusion criteria,and then the information of the included studies was extracted,summarized,and organized for further analysis.Result:A total of 4 RCTs and 21 animal studies(including 13 papers on compound studies,3 papers on single herb studies,and 5 papers on monomer studies)about TCM treatment for CAG were included in this study.RCTs showed that TCM could work well in improving the pathological state of gastric mucosa and clinical symptoms in patients.However,there were problems of low study quality,and non-uniform diagnostic criteria for gastric mucosal pathology and clinical efficiency evaluation.Animal experiments mainly focused on the study of drug mechanism exploration,and their results showed that TCM treatment of CAG was characterized by multi-target action.However,the animal experiments also had some problems such as inconsistence of CAG animal model establishment,positive drug selection,drug intervention methods as well as intervention cycles among different experiments.Conclusion:The efficacy of TCM in the treatment of CAG has gradually gained global recognition,but there is still a need for further standardization and unification of research methods.In the future,high-quality clinical trials and standardized animal experiments are still needed to conduct in-depth studies on the time for intervention,intervention methods,active ingredients and mechanisms of TCM,so as to make contributions to the full understanding and application of TCM in the treatment of CAG.