乌梅丸加减治疗泄泻的Meta分析

Meta-analysis on Modified Wumei Pill in The Treatment of Diarrhea

目的:系统评价乌梅丸加减治疗泄泻的临床疗效。方法:采用计算机及纸质书籍两种方式,综合检索中国知网(CNKI)、维普(VIP)、万方、中国生物医学文献数据库(CBM)及PubMed等数据库中以乌梅丸加减治疗泄泻的随机对照试验(RCT)。提取基本信息及研究数据后进行质量评价,纳入研究的结局指标由Revman5.3软件进行Meta分析。结果:共纳入28篇文献,总计2337名患者。Meta分析结果显示:与西医对照组比较,乌梅丸加减试验组的疗效更优[总有效率OR=4.55,95%CI为(3.52,5.89),Z=11.54,P<0.000 01;中医症候积分改善SMD=-1.51,95%CI为(-2.61,-0.87),Z=4.59,P<0.000 01;安全性评价OR=0.43,95%CI为(0.23,0.79),Z=2.70,P=0.007;降低复发率RR=0.34,95%CI为(0.13,0.86),Z=2.27,P=0.02]。结论:乌梅丸加减治疗泄泻疗效显著,但因纳入文献质量偏低且存在发表偏倚,需要高质量的随机对照试验的支持。

Objective:To systematically evaluate the clinical efficacy of modified Wumei Pill in the treatment of diarrhea.Methods:With both computer and paper books,the randomized controlled trial(RCT)of using Wumei pills to treat diarrhea was comprehensively searched in China National Knowledge Network(CNKI),VIP,Wanfang and China Biomedical Literature Database(CBM)and PubMed and other databases.After extracting the basic information and research data,the quality evaluation was carried out.The outcome indicators of the included research were analyzed by the Revman5.3 software.Results:A total of 28 articles were included,with a total of 2337 patients.Meta-analysis results showed that compared with the western medicine control group,the effect of Wumei pill modified test group was better(total effective rate OR=4.55,95%OR[3.52,5.89],Z=11.54,P<0.00001).TCM symptom scores improved(SMD=-1.51,95%CI was[-2.61,-0.87],Z=4.59,P<0.00001).The safety evaluation was OR=0.43,95%CI was(0.23,0.79),Z=2.70,P=0.007.The recurrence rate was reduced(OR=0.34,95%CI[0.13,0.86],Z=2.27,P=0.02).Conclusion:Wumei pills have a significant effect on the treatment of diarrhea,but due to the low quality of the included literature and publication bias,the support of high-quality randomized controlled trials is needed.