The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China.
Hunan University of Chinese Medicine, Changsha, Hunan, China.
Medicine (Baltimore). 2022 Dec 30;101(52):e32303. doi: 10.1097/MD.0000000000032303.
Chronic atrophic gastritis (CAG) is an important stage of precancerous lesions of gastric cancer, and also a key period of drug intervention. However, there is still a lack of drugs to maintain the treatment of CAG until the advent of moluodan.
This study was conducted to assess the clinical efficacy of moluodan in the treatment of CAG by meta-analysis and trial sequential analysis.
China National Knowledge Infrastructure, China Biology Medicine, VIP, Wanfang, Embase, PubMed, the Cochrane Library, and Web of Science databases were searched, all with the time limit from database establishment to July 2022. The published randomized controlled trials of moluodan for CAG were conducted for meta-analysis and trial sequential analysis.
7 studies with a total sample size of 1143 cases were included. Compared to folic acid/vitamins, moluodan alone significantly increased the effective rate of pathological detection (relative risk [RR] = 1.73, 95% confidence interval [95%CI] = [1.48,2.02], P < .00001), and moluodan in combination with folic acid/vitamins significantly increased the effective rates of pathological detection (RR = 1.37, 95%CI = [1.23,1.52], P < .00001), gastroscopy (RR = 1.37, 95%CI = [1.18,1.60], P < .0001) and symptoms (RR = 1.25, 95%CI = [1.13,1.38], P < .0001). Harbord regression showed no publication bias (P = .22). Quality of evidence evaluation demonstrated moderate quality of evidence for all indicators.
Moluodan can improve the effective rates of pathological examination, gastroscopy and symptoms in patients with CAG, and play a role in slowing down the disease progression and reducing clinical symptoms. It may be a potential drug for the treatment of CAG and has the value of further exploration.
慢性萎缩性胃炎(CAG)是胃癌癌前病变的重要阶段,也是药物干预的关键时期。然而,直到莫罗丹的出现,仍然缺乏治疗 CAG 的药物。
本研究通过荟萃分析和试验序贯分析评估莫罗丹治疗 CAG 的临床疗效。
检索中国知网、中国生物医学文献数据库、维普、万方、Embase、PubMed、Cochrane 图书馆和 Web of Science 数据库,时间均从数据库建立至 2022 年 7 月。对莫罗丹治疗 CAG 的已发表随机对照试验进行荟萃分析和试验序贯分析。
纳入 7 项研究,共 1143 例患者。与叶酸/维生素相比,莫罗丹单药治疗可显著提高病理检测有效率(相对风险 [RR] = 1.73,95%置信区间 [95%CI] = [1.48,2.02],P <.00001),莫罗丹联合叶酸/维生素治疗可显著提高病理检测有效率(RR = 1.37,95%CI = [1.23,1.52],P <.00001)、胃镜(RR = 1.37,95%CI = [1.18,1.60],P <.0001)和症状(RR = 1.25,95%CI = [1.13,1.38],P <.0001)。Harbord 回归未发现发表偏倚(P =.22)。证据质量评价显示,所有指标均为中等质量证据。
莫罗丹可提高 CAG 患者病理检查、胃镜和症状的有效率,对减缓疾病进展、减轻临床症状有一定作用,可能是 CAG 治疗的潜在药物,具有进一步探索的价值。