摘要
目的:对小柴胡汤治疗功能性消化不良(Functional Dyspepsia,FD)肝郁脾虚证的临床疗效及安全性进行系统性评价。方法:系统检索中国知网(CNKI)、维普(VIP)、万方(Wanfang)、PubMed、Embase等数据库,检索出小柴胡汤治疗FD肝郁脾虚证的随机对照试验(RCT),并采用Cochrane评价标准和工具、RevMan5.4软件及STATA15.0软件对纳入的研究进行Meta分析。结果:最终纳入6项研究,总样本量554例,其中治疗组281例,对照组273例。Meta分析结果显示:治疗组对比对照组临床总有效率更高[RR=1.35,95%CI(1.21,1.50),P=0.000<0.05];治疗组对比对照组治疗后中医证候总积分更低[SMD=-1.63,95%CI(-1.86,-1.40),P=0.000<0.05];治疗组对比对照组治疗后血清胃泌素(GAS)水平更高[SMD=2.92,95%CI(2.06,3.78),P=0.000<0.05];治疗组对比对照组治疗后血清胃动素(MTL)水平更高[SMD=2.212,95%CI(1.789,2.635),P=0.000<0.05];纳入文献中治疗组及对照组均无不良反应发生,故未能进行相关分析。结论:基于现有研究及本文分析,小柴胡汤治疗FD肝郁脾虚证能提高患者的临床总有效率,降低中医证候积分,改善血清GAS、MTL水平,但后期仍需要进行更高质量的RCT对研究结果进行进一步验证。
Objective:To systematically evaluate the clinical efficacy and safety of Xiaochaihu decoction in the treatment of Functional Dyspepsia(FD)with liver-stagnation and splee-deficiency syndrome.How:CNKI,VIP,Wanfang,PubMed,Embase and other databases were systematically searched to retrieve the randomized controlled trial(RCT)of Xiaochaihu decoction in the treatment of FD liver-stagnation and splee-deficiency syndrome.Cochrane evaluation criteria and tools,RevMan5.4 software and STATA15.0 software were used to conduct meta-analysis of the included studies.Results:6 studies were included,with a total sample size of 554 cases,including 281 cases in the treatment group and 273 cases in the control group.The results of meta-analysis showed that the total clinical effective rate of the treatment group was higher than that of the control group(RR=1.35,95%CI(1.21,1.50),P=0.000<0.05).The total score of TCM syndrome in the treatment group was lower than that in the control group(SMD=-1.63,95%CI(-1.86,-1.40),P=0.000<0.05).The serum gastrin(GAS)level in the treatment group was higher than that in the control group(SMD=2.92,95%CI(2.06,3.78),P=0.000<0.05).Serum motilin(MTL)level in the treatment group was higher than that in the control group after treatment(SMD=2.212,95%CI(1.789,2.635),P=0.000<0.05).There were no adverse reactions in the treatment group and the control group in the included literature,so the relevant analysis could not be conducted.Conclusion:Based on the existing studies and the analysis in this paper,Xiaochaihu decoction can improve the total clinical effective rate of patients with FD liver-stagnation and splee-deficiency syndrome,reduce TCM syndrome scores,and improve serum GAS and MTL levels.However,higher quality RCT is still needed in the later stage to further verify the research results.
作者
张智凯
张威威
莫德美
ZHANG Zhikai;ZHANG Weiwei;MO Demei(Graduate School of Guangxi University of Traditional Chinese Medicine,N anning Guangxi 530001)
关键词
小柴胡汤
功能性消化不良
肝郁脾虚证
META分析
Xiaobupleurum decoction
Functional dyspepsia
Syndrome of li ver depression and spleen deficiency
meta-analysis