Lin Meisi, Zhang Siyuan, Zhang Minyue, Shi Jinfeng, Zhang Chen, Luo Ruifeng, You Jieshu, Sun Jiayi, Zhang Jinming, Gao Fei
Key Laboratory of Systematic Research of Distinctive Chinese Medicine Resources in Southwest China and Pharmacy School, Chengdu University of Traditional Chinese Medicine.
Sichuan Acupuncture School, Chengdu.
Medicine (Baltimore). 2020 Nov 25;99(48):e23103. doi: 10.1097/MD.0000000000023103.
Kangfuxin (KFX), a well-known Chinese patent medicine which extracted from Periplaneta americana, is widely used as an adjuvant in the treatment of peptic ulcers (PUs) with proton pump inhibitors (PPIs) such as rabeprazole, in China. However, no clear consensus has been reached on the efficacy for PU treatment.
We searched in 7 electronic databases to find randomized controlled trials (RCTs) completed before May 31, 2020 to explore the clinical efficiency of KFX plus rabeprazole in the treatment of PU. Risk ratio (RR) corresponding to 95% confidence interval (CI) was calculated to estimate the outcomes. Publication bias was assessed by both Egger's and Begg's tests. Statistical analyses were performed using RevMan 5.4 and Stata version 10.0.
Twenty-five RCTs, comprising 2555 PU patients, were included in this study. Meta-analysis showed that, when compared with rabeprazole-based treatment alone, KFX plus rabeprazole significantly improved the healing rate (RR = 1.34, 95% CI 1.25-1.44) and overall response rate of ulcers (RR = 1.16, 95% CI 1.13-1.20), alleviated the clinical symptoms of PU (RR = 1.14, 95% CI 1.08-1.21), and reduced the recurrence of PU (RR = 0.38, 95% CI 0.24-0.61) without an increase in the occurrence of adverse events (RR = 0.92, 95% CI 0.66-1.28).
Our study suggests that KFX combined with rabeprazole showed positive therapeutic effects and is safe for treating PU, which may provide more reliable evidence for the clinical use of KFX in the treatment of PU.
康复新(KFX)是一种著名的中成药,由美洲大蠊提取而来,在中国被广泛用作质子泵抑制剂(PPIs)如雷贝拉唑治疗消化性溃疡(PUs)的辅助药物。然而,关于其治疗PU的疗效尚未达成明确共识。
我们检索了7个电子数据库,以查找2020年5月31日前完成的随机对照试验(RCTs),以探讨KFX联合雷贝拉唑治疗PU的临床疗效。计算对应95%置信区间(CI)的风险比(RR)以估计结果。通过Egger检验和Begg检验评估发表偏倚。使用RevMan 5.4和Stata 10.0版本进行统计分析。
本研究纳入了25项RCTs,共2555例PU患者。荟萃分析表明,与单独使用基于雷贝拉唑的治疗相比,KFX联合雷贝拉唑显著提高了愈合率(RR = 1.34,95% CI 1.25 - 1.44)和溃疡的总体缓解率(RR = 1.16,95% CI 1.13 - 1.20),缓解了PU的临床症状(RR = 1.14,95% CI 1.08 - 1.21),并降低了PU的复发率(RR = 0.38,95% CI 0.24 - 0.61),且未增加不良事件的发生率(RR = 0.92,95% CI 0.66 - 1.28)。
我们的研究表明,KFX联合雷贝拉唑显示出积极的治疗效果,且治疗PU安全,这可能为KFX在PU治疗中的临床应用提供更可靠的证据。