甘草泻心汤加减治疗复发性口腔溃疡Meta分析

A Meta Analysis of Modified Licorice Heart-Draining Decoction in the Treatment of Recurrent Aphthous Ulcer

目的:系统评价甘草泻心汤加减治疗复发性口腔溃疡(recurrent aphthous ulcer,RAU)的临床疗效。方法:计算机检索中国知网、万方数据库、维普中文期刊数据库、Embase、Pubmed、The Cochrane Library等数据库,收集国内外公开发表的关于甘草泻心汤加减治疗RAU的随机对照试验(randomized controued trial,RCT)研究,提取相关研究资料,评价纳入文献偏倚风险,采用Revman 5.3软件、GRADEprofiler 3.6分别进行Meta分析、评价证据质量。结果:纳入文献11篇,共803例患者,其中试验组406例,对照组397例。Meta分析结果显示,试验组有效率高于对照组[OR=5.59,95%CI(3.79,8.25),Z=8.86,P<0.000 01]。试验组复发率与对照组比较,差异无统计学意义[OR=0.74,95%CI(0.05,12.10),Z=0.21,P=0.83]。试验组疼痛指数低于对照组[SMD=-1.25,95%CI(-1.58,-0.92),Z=7.49,P<0.000 01]。结论:甘草泻心汤加减治疗RAU疗效优于常规西药法,但因纳入研究的数量和质量有限,上述结论有待更高质量的RCT验证,今后需进行大样本、高质量、多中心的临床RCT研究。

Objective:To observe the clinical curative effect of Modified Licorice Heart-Draining Decoction on recurrent aphthous ulcer(RAU).Methods:We searched CNKI,Wanfang database,VIP Chinese Journal Database,Embase,Pubmed,The Cochrane Library and other databases to collect randomized controlled trials(RCTs) published at home and abroad on the treatment of RAU with Modified Licorice Heart-Draining Decoction,Revman 5.3 software and GRADEprofiler 3.6 software were used respectively to conduct Meta-analysis and evaluate the quality of evidence.Results:A total of 11 articles were included,involving 803 patients,among with 406 in the experimental group and 397 in the control group.The Meta analysis showed that the effective rate of the experimental group was higher than that of the control group [OR=5.59,95%CI(3.79,8.25),Z=8.86,P<0.000 01].There was no significant difference in the recurrence rate between the experimental group and the control group [OR=0.74,95%CI(0.05,12.10),Z=0.21,P=0.83].The pain index of the experimental group was lower than that of the control group [SMD=-1.25,95%CI(-1.58,-0.92),Z=7.49,P<0.000 01].Conclusion:The effect of Modified Licorice Heart-Draining Decoction on RAU is better than that of conventional western medicine.However,due to the limited number and quality of included studies,the above conclusions need to be verified by higher quality RCT,and large sample,high-quality,multi center clinical RCT studies are needed in the future.