Graduate School, Beijing University of Chinese Medicine, No.11, Beisanhuandong Road, Chaoyang District, Beijing 100029, China.
Department of Gastroenterology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Xiyuan Road, Haidian District, Beijing 100091, China.
J Tradit Chin Med. 2019 Aug;39(4):459-465.
To evaluate the effect and safety of Chinese herbal medicines on Helicobacter pylori (HP)-associated gastroduodenal ulcers.
All randomized controlled trials (RCTs) listed in the PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure Database, WanFang, China Science and Technology Journal Database and SinoMed databases that were published in English or Chinese were searched, and the retrieval time range was from database inception to December 31, 2018. A comprehensive Meta-analysis of all publications was performed with RevMan 5.3 software, and the quality of the evidence reported in the results of Meta-analysis was analyzed with GRADE profiler software (version 3.6.1). Dichotomous data were analyzed by calculating odds ratios and 95% confidence intervals (CIs). Outcome measures included the HP clearance rate and percentage of adverse effects.
Eight trials with 919 participants were included in this Meta-analysis. Compared with the effects of single drug therapy on HP-associated gastroduodenal ulcers, according to the statistical analysis, odds ratios for the HP clearance rate and percentage of adverse effects of Chinese herbal medicines administered as complementary medicines combined with drugs were 3.10 [95% CI (2.21, 4.36), P < 0.01] and 0.28 [95% CI (0.15, 0.52), P < 0.01], respectively, and the differences were statistically significant. According to the GRADE analysis, the quality of evidence for the HP clearance rate and percentage of adverse effects were both very low.
Compared with using the drug therapy only, the combination of Chinese herbal medicines with the drug therapy more effectively eliminates HP and alleviates adverse reactions. However, the available studies were of low quality, and therefore more well-designed studies are required to further confirm the findings.
评价中草药治疗幽门螺杆菌（HP）相关胃十二指肠溃疡的疗效和安全性。
检索 PubMed、EMBASE、Cochrane 图书馆、中国知网、万方、中国科技期刊数据库和中国生物医学文献数据库中收录的发表于英文或中文的所有随机对照试验（RCT），检索时间范围为建库至 2018 年 12 月 31 日。采用 RevMan 5.3 软件对所有文献进行综合 Meta 分析，并采用 GRADE profiler 软件（版本 3.6.1）对 Meta 分析结果中的证据质量进行分析。二分类数据采用比值比和 95%置信区间（CI）进行分析。结局指标包括 HP 清除率和不良反应发生率。
纳入 8 项 RCT，共 919 例患者。与单药治疗相比，中草药作为辅助药物联合药物治疗对 HP 相关胃十二指肠溃疡的疗效，HP 清除率的统计分析结果显示，比值比为 3.10（95%CI：2.21，4.36），P<0.01，不良反应发生率的比值比为 0.28（95%CI：0.15，0.52），P<0.01，差异均有统计学意义。根据 GRADE 分析，HP 清除率和不良反应发生率的证据质量均为极低质量。
与单纯药物治疗相比，中草药联合药物治疗更有效地清除 HP 并减轻不良反应。但现有研究质量较低，需要更多设计良好的研究进一步证实上述结论。
