摘要
目的运用Meta分析系统评价芍药汤联合针刺治疗溃疡性结肠炎(ulcerative colitis,UC)的临床疗效,为临床上联合疗法治疗UC提供循证依据。方法利用计算机检索中国知网(CNKI)、PubMed、重庆维普中文数据库(VIP)、中国生物医学数据库(CBM)、万方、Embase以及Cochrane Library等数据库,纳入芍药汤联合针刺治疗UC的所有随机对照实验的文献,由两名研究者严格按照纳入、排除标准筛选文献,最后使用Cochrane协作网提供的Revman 5.1软件对所有纳入研究进行Meta分析。结果最终纳入8篇文献,共计762例患者,试验组采用芍药汤联合针刺治疗,对照组采用芍药汤或针刺或美沙拉嗪等单一疗法治疗。Meta分析结果表明,试验组的总有效率明显优于对照组(OR=5.87,95%CI:3.67,9.37,P<0.00001),且结肠镜评分(MD=-1.58,95%CI:-1.89,-1.28,P<0.00001)、结肠病理评分(MD=-1.57,95%CI:-1.95,-1.20,P<0.00001)都明显低于对照组,差异具有高度统计学意义;临床主要症状评分均明显低于对照组(腹痛:MD=-0.72,95%CI:-0.88,0.56,P<0.00001;腹泻:MD=-0.60,95%CI:-0.78,0.43,P<0.00001;血便:MD=-0.60,95%CI:-0.74,0.46,P<0.00001;里急后重:MD=-0.82,95%CI:-1.03,0.61,P<0.00001;肛门灼热:MD=-0.66,95%CI:-0.75,-0.58,P<0.00001),差异具有高度统计学意义。结论联合治疗方案(芍药汤联合针刺)的总有效率明显高于单一治疗方案,其结肠镜评分、结肠病理评分、临床主要症状评分均优于单一治疗方案,表明该联合治疗方案治疗UC具有较高应用价值,值得临床推广;但该方案的安全性研究较少,这是以后临床研究的重点方向;仍需多中心、大样本、双盲的高质量RCT进一步验证。
Objective To systematically evaluate the clinical efficacy of Shaoyao decoction combined with acupuncture in the treatment of ulcerative colitis(UC)by Meta-analysis,so as to provide an evidence-based basis for clinical combined therapy in the treatment of UC.Methods CNKI,Pubmed,VIP,CBM,Wanfang,Embase,Cochrane Library and other databases were searched for literatures on all randomized controlled trials of Shaoyao decoction combined with acupuncture in the treatment of UC.Two researchers screened the literature in strict accordance with the inclusion and exclusion criteria.Finally,Revman 5.1 software provided by the Cochrane Collaboration was used for Meta-analysis of all the included studies.Results Finally,8 literatures were included,with a total of 762 patients.The experimental group was treated with Shaoyao decoction combined with acupuncture,while the control group was treated with monotherapy of Shaoyao decoction or acupuncture or Mesalazine.Meta-analysis showed that the total effective rate of the experimental group was significantly better than that of the control group(OR=5.87,95%CI:3.67,9.37,P<0.00001),and the colonoscopy score(MD=-1.58,95%CI:-1.89,-1.28,P<0.00001)and colonic pathological score(MD=-1.57,95%CI:-1.95,-1.20,P<0.00001)were significantly lower than those of the control group,and the differences were highly statistically significant.The scores of main clinical symptoms were significantly lower than those of the control group(abdominal pain:MD=-0.72,95%CI:-0.88,0.56,P<0.00001;Diarrhea:MD=-0.60,95%CI:-0.78,0.43,P<0.00001;Blood stool:MD=-0.60,95%CI:-0.74,0.46,P<0.00001;Tenesmus:MD=-0.82,95%CI:-1.03,0.61,P<0.00001;Anal burn:MD=-0.66,95%CI:-0.75,-0.58,P<0.00001),and the difference was highly statistically significant.Conclusion The total effective rate of the combined treatment regimen(Shaoyao decoction combined with acupuncture)was significantly higher than that of the single treatment regimen,and the colonoscopy score,colonic pathological score and clinical main symptom score were better than those of the single treatment regimen,indicating that the combined treatment regimen has high application value in the treatment of UC and is worthy of clinical promotion.However,there are few studies on the safety of this protocol,which is the key direction of future clinical research.Further validation by multi-center,large-sample,double-blind,high-quality RCT is still needed.
作者
李涛
李亚玲
吴莎
李俊
Li Tao;Li Yaling;Wu Sha;Li Jun
出处
《中国疗养医学》
2022年第10期1029-1033,共5页
Chinese Journal of Convalescent Medicine
基金
四川省教育厅重点项目(SCYG2019-04)。
关键词
芍药汤
针刺
溃疡性结肠炎
META分析
联合治疗方案
Shaoyao decoction
Acupuncture
Ulcerative colitis
Meta-analysis
Combined treatment regimen