中医药治疗大肠湿热证溃疡性结肠炎的Meta分析

Meta-analysis of TCM Treating Ulcerative Colitis with Syndrome of Damp-heat in Large Intestine

目的采用Meta分析中医药治疗大肠湿热证溃疡性结肠炎的临床疗效。方法利用计算机检索每个数据库建库至2020年11月国内外权威医学期刊全文数据库。纳入中医药与西药对照的随机对照试验(RCTs),运用Corhrane评价方法对文献的风险偏倚进行评估;对纳入文献的临床疗效、中医症候积分、中医症状疗效进行Meta分析。结果符合标准要求的有9个RCTs,共695例患者。Meta分析结果显示,对比单用西药:(1)中医药治疗大肠湿热证溃疡性结肠炎有更好的临床疗效;(2)中医药治疗大肠湿热证溃疡性结肠炎能更好地降低中医症候积分;(3)中医药治疗大肠湿热证溃疡性结肠炎能有效降低肠道充血水肿情况;(4)中医药治疗大肠湿热证溃疡性结肠炎能明显改善湿热相关中医症状;(5)漏斗图分析不存在发表偏倚。结论与用西药相对比,中医药治疗溃疡性结肠炎有着更好的临床疗效,可降低中医症候积分,改善湿热相关中医症候,减少肠道充血水肿,适合临床的推广使用。不足的是,纳入的文献质量高低不一,缺少复发率和不良反应的报道,因此期望国内开展更多高质量、多中心、大样本的临床研究,详细报告分组隐藏及盲法,为临床治疗溃疡性结肠炎提供高质量的论证依据。

Objective To analyze the clinical efficacy of traditional Chinese medicine in the treatment of ulcerative colitiswith syndrome of damp-heat in large intestine in using Meta-analysis. Methods Computers were used to search the full-text databases of authoritative medical journals at home and abroad for each database from the establishment of the library to November 2020. Randomized controlled trials( RCTs) comparing traditional Chinese medicine and western medicine were included. Corhrane evaluation method was used to evaluate the risk bias of the literature. Meta-analysis of clinical efficacy,TCM syndrome score,and TCM symptom efficacy of the included literature was carried out. Results There were 9 RCTs thatmet the requirements of the standard,with a total of 695 patients. The results of Meta-analysis showed that compared with single use of western medicine,treating ulcerative colitis with syndrome of damp-heat in large intestine had better clinical effect in using TCM. Treating ulcerative colitis with syndrome of damp-heat in large intestine can better reduce TCM syndrome scores in using TCM. Treating ulcerative colitis with syndrome of damp-heat in large intestine can effectively reduce intestinal congestion and edema in using TCM. Treating ulcerative colitis with syndrome of damp-heat in large intestine can significantly improve the symptoms of damp-heat related TCM in using TCM. The funnel chart was used to analyze this study. The results showed that there was no publication bias. Conclusion Compared with western medicine,traditional Chinese medicine has a better clinical effect in the treatment of ulcerative colitis. It can reduce TCM syndrome scores,improve damp-heat-related TCM syndromes,and reduce intestinal congestion and edema,which is suitable for clinical promotion. The disadvantage is that the quality of the included literature varies,and there is a lack of reports on recurrence rates and adverse reactions. Therefore,it is hoped that more high-quality,multi-center,large-sample clinical studies will be carried out in China with detailed reporting group hiding and blind method. This provides high-quality evidence for the clinical treatment of ulcerative colitis.