中药治疗胆汁反流性胃炎的系统评价和网络Meta 分析。

Traditional Chinese patent medicine for bile reflux gastritis: a systematic review and network meta-analysis.

机构信息

Liaoning University of Traditional Chinese Medicine, Shenyang, China.

Department of Gastroenterology, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, China.

出版信息

Ann Palliat Med. 2021 Jul;10(7):7721-7735. doi: 10.21037/apm-21-1307.

DOI:10.21037/apm-21-1307

PMID:34353060

Abstract

BACKGROUND

Traditional Chinese Patent Medicine (TCPM) is widely used in the treatment of bile reflux gastritis (BRG). However, there is still a lack of research evaluating the efficacy of specific drugs. Thus, we conducted a reticulated meta-analysis to compare the efficacy of TCPMs in the treatment of BRG.

METHODS

We searched the China National Knowledge Infrastructure (CNKI), PubMed, Web of Science, and the Wanfang, and Embase databases, as of February 2021, for publications on the treatment of BRG with Chinese patent medicines in randomized controlled trials (RCTs). The main outcome indicator was the effective rate. The secondary outcome indicators were recurrence rate, traditional Chinese medicine (TCM) symptom score, and gastroscopic mucosal score. The Cochrane bias risk assessment tool was used to evaluate the research quality, and RevMan software (5.2) and Stata software (15.0) were used for the network meta-analysis.

RESULTS

A total of 24 studies were included in the meta-analysis. In total, 2,417 patients were included in the meta-analysis, comprising 1,222 patients in the treatment group and 1,195 patients in the control group. The results of the network meta-analysis showed that Weiyankang capsules combined with hydrotalcite had the best effect in the treatment of bile reflux among the 14 interventions. Among the 5 studies that reported recurrence rates, patients administered Shugan Hewei pills had the lowest recurrence rate. A direct comparison showed that TCPMs or TCPMs combined with Western medicines had certain advantages in improving the scores of traditional Chinese medicine symptoms and mucosal scores under gastroscopy.

DISCUSSION

Among all the Chinese patent medicines examined, Weiyankang capsules combined with hydrotalcite appeared to be the best choice for the treatment of BRG. However, due to limitations related to the quantity and quality of the research, more high-quality research needs to be conducted in the future to gather additional evidence.

TRIAL REGISTRATION

The protocol of this network meta-analysis was registered in PROSPERO with ID CRD42021247873.

摘要

背景

传统中药（TCPM）广泛用于治疗胆汁反流性胃炎（BRG）。然而，目前仍缺乏针对特定药物疗效的研究。因此，我们进行了网状荟萃分析，以比较 TCPM 治疗 BRG 的疗效。

方法

我们检索了中国知识基础设施（CNKI）、PubMed、Web of Science、万方和 Embase 数据库，截至 2021 年 2 月，以获取关于随机对照试验（RCT）中用中药治疗 BRG 的出版物。主要结局指标为有效率。次要结局指标为复发率、中医症状评分和胃镜黏膜评分。采用 Cochrane 偏倚风险评估工具评价研究质量，网状 Meta 分析采用 RevMan 软件（5.2）和 Stata 软件（15.0）。

结果

共有 24 项研究纳入 Meta 分析。共纳入 2417 例患者，Meta 分析中治疗组 1222 例，对照组 1195 例。网状 Meta 分析结果显示，在 14 种干预措施中，胃疡安胶囊联合氢氧铝治疗胆汁反流效果最佳。在 5 项报告复发率的研究中，舒肝和胃丸治疗组患者复发率最低。直接比较显示，TCPM 或 TCPM 联合西药在改善中医症状评分和胃镜黏膜评分方面具有一定优势。