Department of Gastroenterology, The Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang 110032, China.
J Tradit Chin Med. 2012 Dec;32(4):515-22. doi: 10.1016/s0254-6272(13)60063-1.
OBJECTIVE: To systematically assess the clinical effectiveness of traditional Chinese medicine (TCM) in the treatment of functional dyspepsia (FD) of liver-stomach disharmony syndrome by meta-analysis. METHODS: Random controlled trials (RCTs) were retrieved from databases, including Pubmed, China national knowledge infrastructure, Wanfang Data, VIP Information, and the Cochrane Library. Trials were selected according to inclusion criteria. The effects of traditional Chinese medicine (TCM) versus prokinetic agents in the treatment of functional dyspepsia (FD) of liver-stomach disharmony syndrome were compared by meta-analysis. RevMan 5.0.24 was used for data analysis. The effective rate was assessed by odds ratios (ORs), and 95% confidence intervals (CIs) were calculated. The cure rate was analyzed by the Peto OR. Simple statistical analysis was chosen to assess the frequency of prescribed Chinese herbs in treating this syndrome. RESULTS: Thirteen trials were included, involving 1153 patients, and these were of poor methodological quality. Twelve studies mentioned the effective rate and cure rate. TCM therapy showed a better clinical effect rate compared with that with prokinetic agents [OR: 3.2, 95% CI (2.27, 4.51)]. The TCM group also had a better cure rate than that in the group of prokinetic agents [Peto OR: 2.26, 95% CI (1.61, 3.18)]. With regard to the frequency of Chinese herbs used in these 13 trials, Baishao (Radix Paeoniae), Chaihu (Radix Bupleuri), and Gancao (Radix Glycyrrhizae) were mostly prescribed, followed by Xiangfu (Rhizoma Cyperi), Zhishi (Fructus Aurantii Immaturus), Zhiqiao (Fructus Aurantii), Foshou (Citrus medica var. sarcodactylis), and Chenpi (Pericarpium Citri Reticulatae). No serious adverse effects were reported. CONCLUSION: TCM therapy shows a superior effective rate and cure rate compared with those in prokinetic agents in the treatment of FD of liver-stomach disharmony syndrome. However, further strictly designed RCTs are required because of the poor quality of included trials.
目的:系统评价中医药治疗肝胃不和型功能性消化不良的临床疗效。
方法:检索 Pubmed、中国知网、万方数据、维普网、Cochrane 图书馆等数据库,纳入中医药治疗肝胃不和型功能性消化不良的随机对照试验(RCT),根据纳入排除标准筛选文献,采用 RevMan 5.0.24 软件进行荟萃分析,比较中医药治疗与促动力药治疗肝胃不和型功能性消化不良的疗效。有效率采用比值比(OR)及其 95%置信区间(CI)表示,治愈率采用 Peto OR 及其 95%CI 表示。对治疗该病的常用中药进行简单频数分析。
结果:共纳入 13 项 RCT,包含 1153 例患者,方法学质量均较低。12 项研究报道了有效率,10 项研究报道了治愈率。中医药治疗的临床疗效优于促动力药[OR:3.2,95%CI(2.27,4.51)],治愈率也优于促动力药[Peto OR:2.26,95%CI(1.61,3.18)]。13 项研究中使用频数较高的中药依次为白芍、柴胡、甘草,其次为香附、枳实、枳壳、佛手、陈皮。未发现严重不良反应。
结论:中医药治疗肝胃不和型功能性消化不良的有效率和治愈率均优于促动力药,但纳入研究质量较低,需要进一步开展严格设计的 RCT 加以验证。
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