半夏泻心汤治疗慢性胃炎随机对照试验的Meta分析

Meta-analysis of randomized controlled trials in using Chinese medicinal herbs of Banxia xiexin decoction for the treatment of chronic gastritis

目的评价半夏泻心汤治疗慢性胃炎的疗效与安全性。方法采用Cochrane循证医学系统评价方法,检索Cochrane图书馆、Cochrane另证医学领域试验注册数据库,MEDLINE、EMBASE、中国生物医学文献数据库以及BIOSIS等数据库。收集比较半夏泻心汤与安慰剂、非特异性治疗、其它中药治疗或西药治疗的随机与半随机对照试验。数据采用Cochrane协作网专用软件RevMan4.1进行统计分析。结果共有18篇随机对照试验1886名病人满足纳入标准。所有试验普遍质量不高,未发现双盲试验。“倒漏斗”图显示不对称,提示存在发表偏倚。与得乐冲剂、非特异性疗法比较,半夏泻心汤在症状和体征改善及抗幽门螺杆菌方面有效,与雷尼替丁、三九胃泰比较,半夏泻心汤对症状和体征改善有效。试验未发现严重的副作用。结论由于存在发表偏倚且文献质量普遍低,尚不能提供半夏泻心汤治疗慢性胃炎疗效的循证医学证据。

Objectives To assess the efficacy and safety of Banxia xiexin decoction for chronic gastritis. Methods Systematic review methods were applied to the following electronic databases for search: the Cochrane Library, the Cochrane Complementary Medicine Field Trials Register, MEDLINE, EMBASE, CBMdisc and BIOSIS. Randomized or quasi-randomized trials in contrast groups were collected,trials including the compound of Chinese medicinal herbs of Banxia xiexin decoction compared with placebo, general non-specific treatment, other Chinese medicinal herbs or west medicine. RevMan4.1 was used in these trials. Results Eighteen randomized controlled trials, including 1 886 patients, met the inclusion criteria. All of the trials were not adequate in methodological quality. There was a significant funnel plot asymmetry. Compared to Dele mix or non-specific treatment, Banxia xiexin decoction(compound of herbs) showed significantly positive effects on clearance of H.pylori and relief of symptom. Compared to Leinitidin and Sanjiuweitai, Banxia xiexin decoction showed significantly positive effects on relief of symptom. There were no significant side-effects in these trials. Conclusion Due to publication bias and low quality of the evidences,the effectiveness of Banxia xiexin decoction in chronic gastritis was not clear.