中成药治疗慢性萎缩性胃炎的网状Meta分析

Mesh Meta-Analysis of Chinese Patent Medicines in the Treatment of Chronic Atrophic Gastritis

目的:系统性评价中成药治疗慢性萎缩性胃炎的可靠性以及有效性。方法:通过计算机检索CNKI、VIP、CBM、WOS、WAN FANG DATA、PUBMED等数据库中成药治疗慢性萎缩性胃炎的RCT研究,检索时间设置为各数据库建库至2021年3月,由两名研究人员合作筛选文献并进行数据提取,当意见出现分歧时,由第3位研究者参与讨论完成。借助RevMan 5.3软件做文献质量与风险偏倚评估,Stata16软件对整理的数据进行分析,运用R软件(4.0.5版本)绘制不同干预措施下的等级图。结果:最终纳入22项RCTs与16项半RCTs,共3884例患者,包括7种中成药。网状Meta分析结果显示,在改善临床症状方面,优先选择枫蓼肠胃康胶囊;香砂养胃丸对于改善内镜下黏膜情况有明显优势;改善病理组织学方面气滞胃痛颗粒较优;抗Hp方面作用明显的是枳术宽中胶囊。结论:在常规西药治疗的基础上联合使用中成药可以提升慢性萎缩性胃炎的临床疗效。但各种中成药所纳入的研究质量存在差异,项目研究结果需更严谨的RCTs来进一步验证。

Objective: To systematically evaluate the reliability and effectiveness of Chinese patent medicines in the treatment of chronic atrophic gastritis. Methods: RCT studies in the treatment of chronic phic gastritis by Chinese patent medicines in CNKI, VIP, CBM,WOS, WAN FANG DATA, PUBMED and other databases were searched by computer. The retrieval time was set to March 2021 when each database was built. Two researchers jointly screened literatures and extracted data. In case of disagreement, the third researcher participated in the discussion. RevMan 5.3 software was used to evaluate literature quality and risk bias, Stata 16 software was used to analyze the collated data, and R software (version 4.0.5) was used to draw grade maps under different interventions. Results: 22 RCTs and 16 semi-RCTs were included, involving 3884 patients, including 7 Chinese patent medicines. The results of mesh Meta-analysis showed that Fengliao Changweikang capsule was preferred in improving clinical symptoms. Xiangsha Yangwei pill has obvious advantages in improving mucosal conditions under endoscopy. Qizhi Weitong granule is better in improving histopathology. Zhizhu Kuanzhong Capsule has a significant anti-Hp effect. Conclusion: Combined use of Chinese patent medicine on the basis of conventional western medicine treatment can improve the clinical efficacy of chronic atrophic gastritis. However, there are differences in the quality of studies included in various Chinese patent medicines, and the research results of the project need to be further verified by more rigorous RCTs.