Fang Wen-Jie, Zhang Xin-Ying, Yang Bo, Sui Shu-Jing, Chen Min, Pan Wei-Hua, Liao Wan-Qing, Zhong Ming, Wang Qing-Cai
Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Mycology, Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai 200003, People's Republic of China.
Chinese Engineer Company 11 Level I clinic, United Nations and African Union Hybrid Operation in Darfur, Sudan.
Afr J Tradit Complement Altern Med. 2017 Jun 5;14(4):297-319. doi: 10.21010/ajtcam.v14i4.33. eCollection 2017.
Chinese herbal decoction (CHD) has been extensively used in the treatment of atrophic gastritis (AG) in China and other Far Eastern countries. We conducted a systematic review and meta-analysis to estimate the efficacy and safety of CHD in AG.
Pubmed, Embase, Cochrane central register of controlled trials (central), VIP, China National Knowledge Infrastructure, Sinomed, Wanfang data were searched (up to December 2015). Randomized controlled trials recruiting patients with AG comparing CHD (alone or with western medicine (WM)) with WM were eligible. Dichotomous data were pooled to obtain relative risk (RR), with a 95% confidence interval (CI).
Forty-two articles including 3,874 patients were identified. CHD, used alone or with WM, had beneficial effect over WM in the improvement of clinical manifestations (RR=1.28; 95% CI 1.22-1.34) and pathological change (RR=1.42; 95% CI 1.30-1.54) for AG patients. However, the eradication effect of CHD was not supported by the existing clinical evidence, because of the significant study heterogeneity (I>50%) and inconsistency between the primary results and sensitivity analysis.
CHD, if prescribed as a complementary therapy to WM, may improve the clinical manifestations and pathological change for AG patients. But its monotherapy for eradication is not supported by enough clinical evidence.
中药汤剂（CHD）在中国及其他远东国家已被广泛用于治疗萎缩性胃炎（AG）。我们进行了一项系统评价和荟萃分析，以评估CHD治疗AG的疗效和安全性。
检索了PubMed、Embase、Cochrane对照试验中央注册库（CENTRAL）、维普资讯、中国知网、中国生物医学文献数据库、万方数据（截至2015年12月）。纳入招募AG患者并比较CHD（单独使用或与西药（WM）联合使用）与WM的随机对照试验。汇总二分类数据以获得相对危险度（RR）及95%置信区间（CI）。
共纳入42篇文章，涉及3874例患者。单独使用或与WM联合使用的CHD在改善AG患者的临床表现（RR = 1.28；95% CI 1.22 - 1.34）和病理变化（RR = 1.42；95% CI 1.30 - 1.54）方面比WM更具优势。然而，由于显著的研究异质性（I²>50%）以及主要结果与敏感性分析之间的不一致性，现有临床证据不支持CHD的根除效果。
如果将CHD作为WM的辅助疗法，可能会改善AG患者的临床表现和病理变化。但其单药根除治疗未得到充分临床证据的支持。
