艾灸与西药治疗慢性萎缩性胃炎疗效比较的Meta分析

Efficacy of Moxibustion Versus Western Medicine for Chronic Atrophic Gastritis:A Meta-analysis

目的:评价艾灸与西药治疗慢性萎缩性胃炎(CAG)的临床疗效及安全性。方法:计算机检索Pubmed、Cochrane Library、Embase、Web of Science、国家知识基础设施数据库(CNKI)、中文科技期刊数据库(CCD)、中国学术期刊数据库(CSPD)、中国生物医学文献数据库(CBM)中有关艾灸对比西药治疗CAG的临床随机对照试验,检索时间均从建库至2021年10月31日,根据本研究设定的纳排标准筛选文献并提取资料。采用“Cochrane偏倚风险评估工具”对纳入文献进行质量评价,采用“RevMan 5.4.1”软件对数据进行分析。结果:最终纳入13篇RCT,共计1062名CAG受试者,但总体纳入文献质量不高。Meta分析结果显示,艾灸治疗在改善CAG患者的临床有效率优于西药组。在改善临床症状方面,艾灸治疗缓解CAG患者胃脘灼痛、胃脘胀满、胃脘痞闷评分方面均优于西药组;在改善胃肠分泌蛋白方面,艾灸改善胃蛋白酶原Ⅰ(PGⅠ)/PGⅡ、G-17水平优于西药组;然而艾灸与西药在改善胃黏膜胃镜有效率、胃镜下及病理评分方面差异无统计学意义。结论:艾灸治疗CAG的疗效优于西药,但受纳入文献质量及数量的局限性,验证艾灸治疗CAG的疗效仍需更多高质量研究。

Objective:To evaluate the clinical efficacy and safety of moxibustion and western medicine in the treatment of chronic atrophic gastritis(CAG).Methods:Clinical randomized controlled trials(RCTs)on the comparison of moxibustion and western medicine in treating CAG were retrieved from the databases including PubMed,Cochrane Library,Embase,Web of Science,CNKI,CCD,CSPD,and CBM from database inception to October 31 st,2021.The research papers were screened out and data were extracted according to the set inclusion and exclusion criteria.The Cochrane risk-of-bias tool was used to evaluate the quality of included papers,and the RevMan 5.4.1 was used for data analysis.Results:Thirteen RCTs were included,involving 1062 patients with CAG,but the overall quality of the included RCTs was not high.As revealed by Meta-analysis results,the clinical effective rate of moxibustion in the treatment of CAG was higher than that of western medicine.In terms of improving clinical symptoms,moxibustion was superior to western medicine in alleviating epigastric burning pain,epigastric fullness,and epigastric stuffiness of CAG patients.In terms of improving gastrointestinal protein,moxibustion was superior to western medicine in improving PG I/PG II and G-17 levels.However,there was no significant difference between moxibustion and western medicine in improving gastroscopic efficiency,and gastroscopic and pathological scores of the gastric mucosa.Conclusion:The efficacy of moxibustion in the treatment of CAG is better than that of western medicine.However,due to the limitations of the quality and quantity of the included RCTs,more high-quality studies are needed to verify the efficacy of moxibustion in the treatment of CAG.