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健脾益气疗法治疗慢性萎缩性胃炎的疗效:一项系统评价与Meta分析

The efficacy of Jianpi Yiqi therapy for chronic atrophic gastritis: A systematic review and meta-analysis.

作者信息

Dai Yun-Kai, Zhang Yun-Zhan, Li Dan-Yan, Ye Jin-Tong, Zeng Ling-Feng, Wang Qi, Hu Ling

机构信息

Institute of Gastroenterology, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.

Institute of Clinical Pharmacology, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.

出版信息

PLoS One. 2017 Jul 24;12(7):e0181906. doi: 10.1371/journal.pone.0181906. eCollection 2017.

Abstract

Jianpi Yiqi therapy (JYT) is a classical therapy in treating chronic atrophic gastritis (CAG), but the clinical effects of it are still contentious. The purpose of this article is to evaluate the efficacy and safety of JYT for CAG. Seven electronic databases including PubMed, Embase, Springer Link, CNKI (China National Knowledge Infrastructure), VIP (Chinese Scientific Journals Database), Wan-fang database, and CBM (Chinese Biomedicine Database) were searched from their inception to November 1, 2016. 13 randomized controlled trials (RCTs) with a total of 1119 participants were identified for analysis. Meta-analyses demonstrated that both JYT (RR 1.41; 95% CI 1.27, 1.57; P < 0.00001) and JYT + western medicine (RR 1.27; 95% CI 1.17, 1.38; P < 0.00001) were more efficacious than only western medicine. Furthermore, JYT had potential improvement on traditional Chinese medicine (TCM) symptoms scores such as stomachache, stomach distention, belching, fatigue, et al. In addition, no serious adverse events were reported in the selected trials. The Cochrane Collaboration's risk of bias tool was evaluated for the weaknesses of methodological quality, while the quality level of Grades of Recommendations Assessment Development and Evaluation (GRADE) evidence classification indicated "Very low". This meta-analysis indicates that JYT may have potential effects on the treatment of patients with CAG. However, due to limitations of methodological quality and small sample size of the included studies, further standardized research of rigorous design should be needed.

摘要

健脾益气疗法(JYT)是治疗慢性萎缩性胃炎(CAG)的经典疗法,但其临床疗效仍存在争议。本文旨在评估JYT治疗CAG的疗效和安全性。检索了包括PubMed、Embase、Springer Link、中国知网(CNKI)、维普中文科技期刊数据库(VIP)、万方数据库和中国生物医学文献数据库(CBM)在内的7个电子数据库,检索时间从建库至2016年11月1日。共纳入13项随机对照试验(RCT),1119名参与者进行分析。Meta分析表明,JYT(RR 1.41;95%CI 1.27,1.57;P<0.00001)和JYT联合西药(RR 1.27;95%CI 1.17,1.38;P<0.00001)均比单纯西药更有效。此外,JYT对胃痛、胃胀、嗳气、乏力等中医症状评分有潜在改善作用。另外,在所选试验中未报告严重不良事件。使用Cochrane协作网的偏倚风险工具评估方法学质量的弱点,而推荐分级评估、制定与评价(GRADE)证据分类的质量水平为“极低”。该Meta分析表明,JYT可能对CAG患者的治疗有潜在作用。然而,由于纳入研究的方法学质量有限且样本量较小,需要进一步开展设计严谨的标准化研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8db9/5524332/3a6a8c424f26/pone.0181906.g001.jpg

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