参灵白术散治疗慢性胃炎的临床疗效及作用机制研究。

BACKGROUND: Chronic gastritis (CG) is an inflammatory disease of the gastric mucosa. Shen-ling-bai-zhu san (SLBZS), a traditional Chinese medicine formula, is widely used for treating CG. Nevertheless, its effects are currently unclear. AIM: To determine the clinical evidence and potential mechanisms of SLBZS for the treatment of CG. METHODS: We systematically searched 3 English (PubMed, Embase, Medline) and 4 Chinese databases (Cochrane Library Central Register of Controlled Trials, China National Knowledge Infrastructure database, Wanfang Data Knowledge Service Platform, and the VIP information resource integration service platform) without language or publication bias restriction. Qualified studies were selected according to pre-set inclusion and exclusion criteria. RevMan 5.3 software was used for meta-analysis and literature quality assessment, Stata 14.0 software was used for sensitivity analysis, GRADE profiler 3.6 was used to evaluate the quality of evidence. And then, network pharmacology analysis was applied to primary research the mechanisms of action of SLBZS on CG. RESULTS: Fourteen studies were finally included, covering 1335 participants. Meta-analysis indicated that: (1) SLBZS was superior to conventional therapies [risk ratio (RR): 1.29, 95% confidence interval (CI): 1.21 to 1.37, < 0.00001]; (2) SLBZS was better than conventional therapies [RR: 0.24, 95% confidence interval (95%CI): 0.11 to 0.55, = 0.0007] in terms of recurrence rate and reversal of positivity (RR: 1.20, 95%CI: 1.11 to 1.30, < 0.00001); and (3) The safety of SLBZS for CG remains unclear. According to the GRADE method, the quality of evidence was not high. Besides, SNZJS might treat CG by acting on related targets and pathways such as EGFR tyrosine kinase inhibitor resistance, the PI3K-Akt signaling pathway, and others. CONCLUSION: SLBZS might be useful in treating CG, but long-term effects and specific clinical mechanisms of it maintain unclear. More samples and high-quality clinical experiments should be assessed and verified in the next step.

背景：慢性胃炎（CG）是一种胃黏膜的炎症性疾病。参苓白术散（SLBZS）是一种中药方剂，广泛用于治疗 CG。然而，其疗效目前尚不清楚。

目的：确定 SLBZS 治疗 CG 的临床证据和潜在机制。

方法：我们系统地检索了 3 个英文（PubMed、Embase、Medline）和 4 个中文数据库（Cochrane 图书馆对照试验中心注册、中国国家知识基础设施数据库、万方数据知识服务平台和 VIP 信息资源整合服务平台），没有语言或出版偏倚限制。根据预先设定的纳入和排除标准选择合格的研究。使用 RevMan 5.3 软件进行荟萃分析和文献质量评估，使用 Stata 14.0 软件进行敏感性分析，使用 GRADE profiler 3.6 评估证据质量。然后，进行网络药理学分析，初步研究 SLBZS 治疗 CG 的作用机制。

结果：最终纳入了 14 项研究，共涵盖 1335 名参与者。荟萃分析表明：（1）SLBZS 优于常规疗法[风险比（RR）：1.29，95%置信区间（95%CI）：1.21 至 1.37，<0.00001]；（2）SLBZS 在复发率和阳性逆转方面优于常规疗法[RR：0.24，95%CI（95%CI）：0.11 至 0.55，=0.0007]；（3）SLBZS 治疗 CG 的安全性尚不清楚。根据 GRADE 方法，证据质量不高。此外，SNZJS 可能通过作用于相关靶点和途径，如表皮生长因子受体酪氨酸激酶抑制剂耐药、PI3K-Akt 信号通路等，来治疗 CG。

结论：SLBZS 可能对 CG 有一定疗效，但长期疗效和具体的临床机制尚不清楚。下一步应评估和验证更多的样本和高质量的临床试验。