加减半夏厚朴汤联合PPI治疗反流性食管炎临床疗效的Meta分析

Modified Banxia Houpu Decoction Combined with PPI Meta analysis of clinical efficacy of reflux esophagitis

目的 系统研究加减半夏厚朴汤联合PPI治疗反流性食管炎的疗效,为临床治疗反流性食管炎提供参考。方法 计算机检索中国知网数据库(CKNI)、万方数据库(Wang Fang)、维普中文科技期刊全文数据库(VIP)以及Pubmed数据库从2010年至今关于半夏厚朴汤联合PPI治疗反流性食管炎的随机对照试验,利用Cochrane中的偏倚风险评估方法(Risk of bias tool)对纳入文献的质量及偏倚风险进行评估,使用RevMan 5.4软件对加减半夏厚朴汤联合PPI治疗反流性食管炎的有效率进行Meta分析。结果 研究共纳入8篇文献,共652例患者。Meta分析结果表明:与PPI单药治疗反流性食管炎相比,半夏厚朴汤联合PPI疗效更优,差异具有统计学意义[OR=0.40,95%CI(0.26~0.61),P <0.000 1]。有3篇研究报告了胃镜下治疗的有效率,共有272例患者,结果显示两组胃镜下有效率差异有统计学意义[OR=0.49,95%CI(0.25~0.93),P=0.03],表明与PPI单药治疗相比,半夏厚朴汤联合PPI治疗反流性食管炎的胃镜下有效率更优。有5篇研究通过临床症状评分评估其有效率并得出报告,共有380例患者,结果提示两组临床症状评分差异有统计学意义[OR=0.34,95%CI(0.19~0.60),P=0.000 2],表明与PPI单药治疗相比,半夏厚朴汤联合PPI治疗反流性食管炎的临床症状较前改善。结论 加减半夏厚朴汤联合PPI治疗反流性食管炎的疗效优于PPI单药。

Objective To systematically study the efficacy of modified Banxia Houpu decoction combined with PPI in the treatment of reflux esophagitis, and to provide reference for clinical treatment of reflux esophagitis. Methods The randomized controlled trials of Banxia Houpu decoction combined with PPI in the treatment of reflux esophagitis from 2010 to now were searched in Ckni database, Wang Fang database, VIP database and PubMed database. The quality and risk of bias of the included literature were evaluated by using the risk of bias tool in Cochrane, and Revman 5 The effective rate of modified Banxia Houpu decoction combined with PPI in the treatment of reflux esophagitis was meta analyzed by software. Results Eight articles were included in the study, including 652 patients. Meta analysis showed that Banxia Houpu decoction combined with PPI was more effective than PPI in the treatment of reflux esophagitis [OR = 0.40, 95% CI(0.26 ~ 0.61), P < 0.0001]. Three studies reported the effective rate of treatment under gastroscope, with 272 patients in total. The results showed that there was a statistically significant difference in the effective rate under gastroscope between the two groups [OR = 0.49, 95% CI(0.25 ~ 0.93), P = 0.03], indicating that the effective rate under gastroscope of Pinellia Magnolia Decoction combined with PPI in treating RE was better than that of PPI alone.There were 5 studies that evaluated their effectiveness through clinical symptom scores and reported that there were 380 patients in total. The results showed that the difference in clinical symptom scores between the two groups was statistically significant [OR = 0.34, 95% CI(0.19 ~ 0.60), P = 0.0002], indicating that the clinical symptoms of RE treated with Banxia Houpu Decoction combined with PPI were improved compared with PPI alone. Conclusion Modified Banxia Houpu decoction combined with PPI is better than PPI in the treatment of reflux esophagitis.