中药口服联合美沙拉嗪治疗溃疡性结肠炎临床疗效Meta分析

A meta-analysis of clinical efficacy of oral Chinese medicine plus mesalazine on ulcerative colitis

目的:系统评价中药口服联合美沙拉嗪治疗溃疡性结肠炎的临床疗效。方法:通过检索知网、万方、维普、CBM、PubMed、Cochrane Library数据库获得文献,将最终纳入的文献采用RevMan 5.3软件进行Meta分析。结果:最终纳入文献27篇,全部为随机对照试验。结果表明,中药口服联合美沙拉嗪治疗溃疡性结肠炎患者在提高临床总有效率[相对危险度(RR)=1.22,95%可信区间(CI)(1.18,1.27),P<0.00001]、改善中医证候[加权均数差(WMD)=-1.20,95%CI(-1.42,-0.99),P<0.00001]、降低炎症指标及复发率[RR=0.38,95%CI(0.24,0.62),P<0.0001]等方面优于单用美沙拉嗪;其中,肿瘤坏死因子-α[标准化均数差(SMD)=-2.01,95%CI(-2.74,-1.27),P<0.00001]、C反应蛋白[WMD=-1.79,95%CI(-2.64,-0.93),P<0.0001]。而白细胞介素-1β[WMD=-1.12,95%CI(-2.61,0.37),P=0.14],进行敏感性排异后得出1组排除陈利坚得[SMD=-1.46,95%CI[-1.74,-1.17],P=0.90,I^(2)=0%,Z=10.12,P<0.00001],2组排除王威得[SMD=-3.33,95%CI[-3.76,-2.91],P=0.56,I^(2)=0%,Z=15.44,P<0.00001]。结论:中药联合美沙拉嗪治疗后溃疡性结肠炎患者的临床疗效显著提升,且中医证候明显改善,提高了生活质量。因此,中药联合美沙拉嗪治疗可提高溃疡性结肠炎临床治愈率和生活质量。

Objective:To systematically evaluate the clinical efficacy of oral Chinese medicine plus mesalazine on ulcerative colitis.Methods:The literatures were obtained by searching CNKI,WANFANG,VIP,CBM,PubMed and Cochrane Library databases,and the final included literatures were meta-analyzed by RevMan 5.3 software.Results:A total of 27 literatures were included,all of which were randomized controlled clinical trials.Meta-analysis showed that the treatment of UC patients with oral Chinese medicine plus mesalazine could improve the total clinical effective rate[RR=1.22,95%CI(1.18,1.27),P<0.00001]and improve TCM symptoms[WMD=-1.20,95%CI(-1.42,-0.99),P<0.00001];decline the inflammatory biomarkers and the recurrence rate[RR=0.38,95%CI(0.24,0.62),P<0.0001]was superior to mesalazine alone,among which TNF-α[SMD=-2.01,95%CI(-2.74,-1.27),P<0.00001],CRP[WMD=-1.79,95%CI(-2.64,-0.93),P<0.0001],after sensitivity rejection:group 1 excluded CHEN Lijian’s[SMD=-1.46,95%CI[-1.74,-1.17],P=0.90,I^(2)=0%,Z=10.12,P<0.00001];two groups excluded WANG Wei 2017[SMD=-3.33,95%CI[-3.76,-2.91],P=0.56,I^(2)=0%,Z=15.44,P<0.00001].Conclusion:The clinical efficacy of UC patients treated with traditional Chinese medicine plus mesalazine was significantly improved,and the symptoms of traditional Chinese medicine were obviously improved,thus improving the quality of life.Therefore,Chinese medicine plus mesalazine can improve the clinical cure rate and quality of life of UC.