柴胡疏肝散合四君子汤加减方治疗慢性萎缩性胃炎的文献分析

Literature Analysis of Modified Chaihu Shugan Powder Combined with Sijunzi Decoction in Treatment of Chronic Atrophic Gastritis

目的:系统评价柴胡疏肝散合四君子汤加减方治疗慢性萎缩性胃炎(chronic atrophic gastritis,CAG)的临床效果。方法:电子计算机检索中国知网(CNKI)、万方数据库(WANFANG DATA)、中国生物医学文献数据库(CBM)、中国科技期刊全文数据库(VIP)、Cochrane Library、Pubmed、Embase数据库,检索时间限定为建库至2020年8月17日,纳入所有柴胡疏肝散合四君子汤加减方治疗CAG的随机对照试验(randomized controlled trial,RCT),并运用RevMan5.3软件进行Meta分析。结果:最终纳入7项研究共606例CAG患者,Meta分析结果显示与对照组常规西药治疗方案比较,柴胡疏肝散合四君子汤加减方可提高CAG患者的临床总有效率[RR=1.23,95%CI(1.16,1.31),P<0.00001],降低CAG不良反应发生率[RR=0.18,95%CI(0.05,0.58),P=0.004]和CAG的复发率[RR=0.30,95%CI(0.13,0.70),P=0.005],差异有统计学意义;分层分析显示对照组吗丁啉、奥美拉唑、硫糖铝混悬液3种药物联合使用治疗CAG有效率高于其他2种药物合用(P<0.05),维酶素、果胶铋2种药物联合使用治疗CAG疗效最差(P<0.05);漏斗图分析结果显示不对称可能存在发表偏倚。结论:基于纳入7项研究的Meta分析结果,柴胡疏肝散合四君子汤加减方治疗CAG的临床疗效优于常规西药。

Objective:To systematically evaluate the clinical efficacy of Modified Chaihu Shugan powder combined with Sijunzi decoction in treatment of chronic atrophic gastritis(CAG).Methods:Search the databases of CNKI,Wangfang,CBM,VIP,Cochrane Library,PubMed and Embase,the retrieval time ranged from the establishment of the database to August 17,2020.All the randomized controlled trials(RCTs)of Modified Chaihu Shugan Powder combined with Sijunzi decoction in treating CAG were searched and RevMan5.3 software was used for Meta-analysis.Result:A total of 606 patients with CAG were included in seven studies.Compared with western medicine,Modified Chaihu Shugan powder combined with Sijunzi decoction can improve the clinical total effective rate of CAG patients[RR=1.23,95%CI(1.16,1.31),P<0.00001],reduce adverse effects rate[RR=0.18,95%CI(0.05,0.58),P=0.004]and recurrence rate[RR=0.30,95%CI(0.13,0.70),P=0.005]in CAG patients.Stratified analysis showed that,in the control group,the effective rate of combination treatment of Morpholine,Omeprazole and Saccharide was higher than that of other two drugs combination treatments in CAG(P<0.05).The combination treatment of Vitrease and Pectin-bismuth had the worst efficacy in the treatment of CAG(P<0.05).The results of the funnel plot analysis showed asymmetric distribution,indicating that there was a great likelihood of publication bias.Conclusion:Based on the Meta-analysis results of the 7 included studies,the clinical efficacy of Modified Chaihu Shugan powder combined with Sijunzi decoction was better than that of conventional western medicine in the treatment of CAG.