半夏泻心汤治疗功能性消化不良有效性和安全性的Meta分析

The Efficacy and Safety of Banxia Xiexin Decoction in Treating Functional Dyspepsia:A Meta-Analysis

目的:系统评价《伤寒论》经方半夏泻心汤治疗功能性消化不良的疗效及其安全性。方法:计算机检索Cochrane Library、PubMed、Web of Science、Embase、万方数据库、中国知网、维普数据库和中国生物医学文献数据库。检索对象为从建库到2022年2月1日收录的所有半夏泻心汤治疗功能性消化不良临床随机对照试验相关文献并对所纳入文献的质量进行评价。采用RevMan 5.3进行Meta分析。结果:Meta分析结果显示,半夏泻心汤治疗FD有效率RR=1.25,95%CI[1.19,1.32];半夏泻心汤降低FD患者综合症状评分WMD=-1.90,95%CI[-2.53,-1.28];缓解腹痛WMD=-1.45,95%CI[-2.20,-0.69];缓解腹胀WMD=-0.79,95%CI[-1.01,-0.57];缓解嗳气WMD=-0.42,95%CI[-0.67,-0.16];缓解反酸WMD=-0.40,95%CI[-0.75,-0.04];降低胃半排空时间:MD=-10.19,95%CI[-14.79,-5.59];降低胃全排空时间:MD=-25.00,95%CI[-29.31,-20.69];提升胃蠕动幅度(短直径):MD=0.25,95%CI[0.16,0.34];提升胃蠕动幅度(长直径):MD=0.97,95%CI[0.89,1.05];提升胃蠕动频率:MD=1.07,95%CI[0.29,1.85];减少胃肥大细胞个数:MD=-5.15,95%CI[-7.69,-2.61];增加胆囊收缩素分泌:MD=18.25,95%CI[10.61,25.89];增加胃动素分泌MD=39.01,95%CI[30.35,47.66]。所纳入的文献中没有报道使用半夏泻心汤后发生不良反应。结论:研究发现半夏泻心汤可以有效治疗功能性消化不良,改善腹痛、腹胀、嗳气等相关症状、增加胃肠动力和胃肠激素分泌,且使用半夏泻心汤治疗无明显不良反应。为临床治疗功能性消化不良提供新的思路,未来需要更多高质量的试验加以验证。

Objective:To systematically evaluate the efficacy and safety of the treatment of functional dyspepsia with Banxia Xiexin decoction(a classical formula of“Treatise on Febrile Diseases”).Methods:The Cochrane Library,PubMed,Web of Science,Embase,Wanfang database,CNKI,VIP database and CBMdisc were searched.All clinical randomized controlled trials on the treatment of functional dyspepsia with Banxia Xiexin decoction from the date of establishment of the database to February 1,2022 were searched and the quality of the included literature was evaluated.Meta-analysis was performed using RevMan 5.3.Results:The results of Meta-analysis showed that the efficiency of Banxia Xiexin decoction in the treatment of FD:RR=1.25,95%CI[1.19,1.32];Banxia Xiexin decoction decreasing the composite symptom score of FD patients:WMD=-1.90,95%CI[-2.53,-1.28];relieving abdominal pain:WMD=-1.45,95%CI[-2.20,-0.69];relieving abdominal distention:WMD=-0.79,95%CI[-1.01,-0.57];relieving belching:WMD=-0.42,95%CI[-0.67,-0.16];relieving acid reflux:WMD=-0.40,95%CI[-0.75,-0.04];reducing gastric half emptying time:MD=-10.19,95%CI[-14.79,-5.59];reducing gastric total emptying time:MD=-25.00,.95%CI[-29.31,-20.69];increasing gastric peristaltic amplitude(short diameter):MD=0.25,95%CI[0.16,0.34];increasing gastric peristaltic amplitude(long diameter):MD=0.97,95%CI[0.89,1.05];increasing gastric peristaltic frequency:MD=1.07,95%CI[0.29,1.85];reducing gastric mast cells number:MD=-5.15,95%CI[-7.69,-2.61];increasing cholecystokinin secretion:MD=18.25,95%CI[10.61,25.89];increasing the secretion of motilin:MD=39.01,95%CI[30.35,47.66].Conclusion:It was found that Banxia Xiexin decoction can effectively treat functional dyspepsia and relieve abdominal pain,abdominal distension,belching and other related symptoms,increase gastrointestinal motility and gastrointestinal hormone secretion,and there was no obvious adverse reaction in the treatment.It provides evidences for the clinical treatment of functional dyspepsia,which needs to be verified by more high-quality experiments in the future.