一贯煎加减方治疗慢性胃炎的系统评价与Meta分析

Systematic evaluation and Meta analysis of modified Yiguanjian for treating chronic gastritis

[目的]系统评价一贯煎加减方治疗慢性胃炎的临床效果以及安全性。[方法]首先全面检索The Cochrane Library,Pubmed,中国知网(CNKI),维普数据库(VIP)和万方数据库(WanFang),查找截至2022年2月的一贯煎治疗慢性胃炎的随机对照试验,根据Cochrane风险偏倚评估工具对纳入的文献进行评价,采用Review Manager 5.4软件进行定量合成。[结果]最终纳入13项研究,共1357例患者,其中一贯煎组697例,常规组660例。Meta分析结果显示:与常规治疗方案相比,一贯煎加减方治疗能有效提高慢性胃炎患者临床疗效,总有效率的合并效应量和95%的置信区间为[OR=4.86,95%CI(3.39,6.97),P<0.00001],并且均优于西药组和中成药组。此外,相较于常规治疗组,一贯煎加减方可显著提高胃镜改善率[OR=3.43,95%CI(1.47,8.01),P<0.00001];提高幽门螺杆菌(Hp)转阴率[OR=17.07,95%CI(6.62,44.04),P<0.00001)];改善血清胃蛋白酶原I(PGI)[MD=12.05,95%CI(8.25,15.84),P<0.00001];降低不良反应发生率。[结论]根据已有研究数据,一贯煎加减方治疗慢性胃炎同常规治疗组相比临床疗效更佳,安全性更好,并且能提高胃镜改善率和Hp转阴率以及降低血清PGI水平。但由于纳入文献质量不高,结论需要更多高质量研究加以验证。

[Objective]To systematically evaluate the clinical effect and safety of Yiguanjian in the treatment of chronic gastritis.[Methods]First,the Cochrane Library,Pubmed,China Journal Full text Database(CNKI),China Science and Technology Journal Full text Database(VIP),Wanfang Database,etc.were comprehensively searched to find out the randomized controlled trials of the treatment of chronic gastritis with Yiguanjian as of February 2022.The included literature was evaluated according to the Cochrane risk bias assessment tool,and quantitative synthesis was carried out with the Review Manager 5.4 software.[Results]Totally 1357 patients were included in 13 studies,including 697 patients in the Yiguanjian group and 660 patients in the routine group.Meta analysis results showed that,compared with the conventional treatment scheme,the treatment of Yiguanjian could effectively improve the clinical efficacy of patients with chronic gastritis.The combined effect amount and 95%confidence interval of the total effective rate were[OR=4.86,95%CI(3.39,6.97),P<0.00001],and both were superior to the western medicine group and the Chinese patent medicine group.In addition,compared with the conventional treatment group,the improved rate of gastroscopy was significantly increased by the addition and subtraction of Yiguanjian[OR=3.43,95%CI(1.47,8.01),P<0.00001];improve the negative rate of HP[OR=17.07,95%CI(6.62,44.04),P<0.00001)];improve the serum PGI of pepsin[MD=12.05,95%CI(8.25,15.84),P<0.00001];reduce the incidence of adverse reactions.[Conclusion]According to the existing research data,the clinical efficacy and safety of Yiguanjian in the treatment of chronic gastritis are better than those of the conventional treatment group,and it can improve the improvement rate of gastroscope,turn negative rate of HP and reduce the level of serum PGI of pepsin.However,due to the low quality of the included literature,the conclusion needs more high-quality research to verify.