Dai Yun-Kai, Wu Yun-Bo, Wen Hao, Li Ru-Liu, Chen Wei-Jing, Tang Chunzhi, Lu Liming, Hu Ling
Institute of Gastroenterology, Guangzhou University of Chinese Medicine, Guangzhou, China.
Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China.
Front Pharmacol. 2020 Jul 16;11:884. doi: 10.3389/fphar.2020.00884. eCollection 2020.
BACKGROUND/AIMS: Traditional Herbal Medicines (THM) have been being used for gastroesophageal reflux disease (GERD) for a long time, but clinical evidence is still scarce. We evaluated different THM prescriptions for GERD in adults.
Data added to nine online databases from their inception to November 30, 2019, were systematically searched. All relevant randomized controlled trials (RCTs) were included and were combined with Bayesian network analysis. The Cochrane Collaboration's risk of bias tool and GRADE profiler version 3.6 were respectively employed to evaluate the quality of evidence of outcomes.
Seventeen publications involving 1441 participants were retrieved. The results of our analysis suggested that Jianpi therapy+proton pump inhibitors (PPIs) and Ligan Hewei therapy respectively ranked first in overall clinical efficacy and efficacy under gastroscope; Ligan Hewei therapy+PPIs was the optimum intervention in the improvement of acid regurgitation and heartburn.
This research indicates that Ligan Hewei therapy and Jianpi therapy, or these therapies separately combined with PPIs, should be recommended as appropriate complementary and alternative treatments based on the specific characteristics of GERD. However, additional well-designed RCTs with high methodological quality are still needed for future research.
背景/目的：传统草药 medicine（THM）长期以来一直用于治疗胃食管反流病（GERD），但临床证据仍然匮乏。我们评估了成人 GERD 的不同 THM 处方。
系统检索了从九个在线数据库建立至 2019 年 11 月 30 日期间添加的数据。纳入所有相关的随机对照试验（RCT），并结合贝叶斯网络分析。分别采用 Cochrane 协作网的偏倚风险工具和 GRADE 剖析器 3.6 版来评估结局的证据质量。
检索到 17 篇涉及 1441 名参与者的文献。我们的分析结果表明，健脾疗法+质子泵抑制剂（PPI）和理气和胃疗法在总体临床疗效和胃镜下疗效方面分别排名第一；理气和胃疗法+PPI 是改善反酸和烧心的最佳干预措施。
本研究表明，应根据 GERD 的具体特点，推荐理气和胃疗法和健脾疗法，或这些疗法分别与 PPI 联合使用，作为适当的补充和替代治疗方法。然而，未来的研究仍需要更多设计良好、方法学质量高的 RCT。
