白头翁汤加减联合中药灌肠治疗溃疡性结肠炎的Meta分析

A Meta-analysis on efficacy of modified Baitouweng Decoction combined with Chinese herbal enema in treatment of ulcerative colitis

目的系统评价白头翁汤加减联合中药灌肠对治疗溃疡性结肠炎(UC)的疗效及对患者溃疡性结肠炎症状的改善。方法计算机检索PubMed、中国知网(CNKI)、中国生物医学文献数据库(CBM)、维普数据库(VIP)、万方数据库(WF)、读秀数据库(DX),纳入建库以来到2022年11月的中英文文献;根据纳入与排除标准进行筛选,使用ReviewManager5.3进行数据分析,利用Cochrane偏倚风险测评工具进行发表偏倚风险评估,借助Stata16.0进行敏感性分析。结果最终纳入11篇文献,涉及患者1020例。Meta分析结果表明:试验组(接受口服白头翁汤或中药灌肠)的临床有效率高于对照组。在升高CD4^(+)/CD8^(+)比值、降低TNF-α、提高IL-10方面,试验组均优于对照组。结论白头翁汤加减联合中药灌肠治疗溃疡性结肠炎较常规西医疗法有效率显著提高,能有效缓解溃疡性结肠炎症状,可初步认为该方法干预安全性较好。鉴于纳入研究总体质量较低,仍须更多高质量随机对照试验予以验证。

Objective To systematically evaluate the efficacy of modified Baitouweng Decoction combined with traditional Chinese medicine enema in the treatment of ulcerative colitis(UC)and the improvement of symptoms of patients with ulcerative colitis.Methods PubMed,China National Knowledge Infrastructure(CNKI),China Biomedical Literature Database(CBM),Vip Database(VIP),Wanfang Database(WF),and Readshow Database(DX)were searched by computer,and the Chinese and English documents from the establishment of the database to November 2022 were included;Screening is conducted according to the inclusion and exclusion criteria,using ReviewManager5.3 for data analysis,Cochrane bias risk assessment tool for publication bias risk assessment,and Stata16.0 for sensitivity analysis.Results Eleven articles were ultimately included,involving 1020 patients.The Meta-analysis results showed that the clinical effective rate of the experimental group(receiving oral Baitouweng Decoction or traditional Chinese medicine enema)was higher than that of the control group.The experimental group was superior to the control group in increasing the CD4^(+)/CD8^(+)ratio,reducing TNF-α,and increasing IL-10.Conclusion The efficacy of modified Baitouweng Decoction combined with traditional Chinese medicine enema in the treatment of ulcerative colitis is significantly higher than that of conventional western medicine,which can effectively relieve the symptoms of ulcerative colitis.It can be preliminarily considered that this method is safe for intervention.In view of the low overall quality of the included studies,more high-quality randomized controlled trials are still needed to verify.