Zou Jun-Bo, Zhang Xiao-Fei, Shi Ya-Jun, Tai Jia, Wang Yu, Liang Yu-Lin, Wang Fang, Cheng Jiang-Xue, Wang Jing, Guo Dong-Yan
Shaanxi Province Key Laboratory of New Drugs and Chinese Medicine Foundation Research; Pharmacy College, Shaanxi University of Chinese Medicine, Xianyang, China.
Key Laboratory of Modern Prepararation of Traditional Chinese Medicine, Ministry of Education, Jiangxi University of Traditional Chinese Medicine, Nanchang, China.
Evid Based Complement Alternat Med. 2019 Sep 30;2019:1324969. doi: 10.1155/2019/1324969. eCollection 2019.
To evaluate the clinical efficacy and safety of Kangfuxin liquid (KFX) combined with proton pump inhibitors (PPIs) in the treatment of gastric ulcer (GU).
Electronic databases including PubMed, Wanfang, CNKI, VIP, Embase, Cochrane Library, and CBM were examined for appropriate articles without language limitations on key words before March 10, 2019. RevMan 5.3 software was applied to execute outcome assessment and finish the meta-analysis.
22 articles involving 2,024 patients with a gastric ulcer were selected. Total efficacy rate and efficacy rate of gastroscopy were significantly enhanced for the combination of KFX with PPIs compared to those of PPI treatment alone (OR = 6.95, 95% CI: 4.87, 9.91, < 0.00001; OR = 2.96, 95% CI: 1.98, 4.42, < 0.00001, respectively). Same results were found for different PPIs in combination on total efficacy rate, respectively. The combination also significantly reduced the adverse events (OR = 0.39, 95% CI: 0.22, 0.70, =0.002). In addition, KFX combined with PPI could suppress the inflammation (MD = -6.11, 95% CI: -7.45, -4.77, < 0.00001), reduce the recurrence rate (OR = 0.31, 95% CI: 0.14, 0.70, =0.005), and enhance the clearance rate of (HP, OR = 3.76, 95% CI: 1.80, 7.87, =0.0004). It seemed like the combination would influence immune function by increasing levels of T-lymphocyte subsets CD4 and CD8 but not CD3 (MD = 2.40, 95% CI: 1.25, 3.55, < 0.0001); MD = 25.72, 95% CI: 14.55, 36.90, < 0.00001; MD = 0.72, 95% CI: -0.66, 2.09, =0.31, respectively).
KFX combined with PPIs in treatment of patients with GU could improve the total efficacy rate and efficacy rate of gastroscopy and reduce adverse events and the recurrence rate. However, the results of this study should be handled with care due to the limitations. Several rigorous RCTs are in need to confirm these findings.
评估康复新液(KFX)联合质子泵抑制剂(PPIs)治疗胃溃疡(GU)的临床疗效及安全性。
检索包括PubMed、万方、知网、维普、Embase、Cochrane图书馆和中国生物医学文献数据库在内的电子数据库,查找2019年3月10日前发表的有关关键词且无语言限制的合适文章。应用RevMan 5.3软件进行结果评估并完成荟萃分析。
选取22篇涉及2024例胃溃疡患者的文章。与单独使用PPI治疗相比,KFX联合PPIs治疗的总有效率和胃镜检查有效率显著提高(OR = 6.95,95%CI:4.87,9.91,P < 0.00001;OR = 2.96,95%CI:1.98,4.42,P < 0.00001)。不同PPIs联合使用时总有效率也得到相同结果。联合使用还显著减少了不良事件(OR = 0.39,95%CI:0.22,0.70,P = 0.002)。此外,KFX联合PPI可抑制炎症(MD = -6.11,95%CI:-7.45,-4.77,P < 0.00001),降低复发率(OR = 0.31,95%CI:0.14,0.70,P = 0.005),并提高幽门螺杆菌(HP)清除率(OR = 3.76,95%CI:1.80,7.87,P = 0.0004)。联合使用似乎通过增加T淋巴细胞亚群CD4和CD8水平而非CD3水平来影响免疫功能(MD = 2.40,95%CI:1.25,3.55,P < 0.0001);MD = 25.72,95%CI:14.55,36.90,P < 0.00001;MD = 0.72,95%CI:-0.66,2.09,P = 0.31)。
KFX联合PPIs治疗GU患者可提高总有效率和胃镜检查有效率,减少不良事件和复发率。然而,由于本研究存在局限性,其结果应谨慎对待。需要多项严格的随机对照试验来证实这些发现。