Zhao Zhi-Hui, Dong Yi-Hang, Jiang Xin-Qi, Wang Jing, Qin Wan-Li, Liu Zhang-Yi, Zhang Xiao-Qing, Wei Yu-Jie
School of Life Sciences, Beijing University of Chinese Medicine, Beijing 102488, China.
School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 102488, China.
World J Clin Cases. 2024 Aug 6;12(22):5067-5082. doi: 10.12998/wjcc.v12.i22.5067.
Currently, traditional Chinese medicine (TCM) formulas are commonly being used as adjunctive therapy for ulcerative colitis in China. Network meta-analysis, a quantitative and comprehensive analytical method, can systematically compare the effects of different adjunctive treatment options for ulcerative colitis, providing scientific evidence for clinical decision-making.
To evaluate the clinical efficacy and safety of commonly used TCM for the treatment of ulcerative colitis (UC) in clinical practice through a network meta-analysis.
Clinical randomized controlled trials of these TCM formulas used for the adjuvant treatment of UC were searched from the establishment of the databases to July 1, 2022. Studies that met the inclusion criteria were screened and evaluated for literature quality and risk of bias according to the Cochrane 5.1 standard. The methodological quality of the studies was assessed using ReviewManager (RevMan) 5.4, and a funnel plot was constructed to test for publication bias. ADDIS 1.16 statistical software was used to perform statistical analysis of the treatment measures and derive the network relationship and ranking diagrams of the various intervention measures.
A total of 64 randomized controlled trials involving 5456 patients with UC were included in this study. The adjuvant treatment of UC using five TCM formulations was able to improve the clinical outcome of the patients. Adjuvant treatment with Baitouweng decoction (BTWT) showed a significant effect [mean difference = 36.22, 95% confidence interval (CI): 7.63 to 65.76]. For the reduction of tumor necrosis factor in patients with UC, adjunctive therapy with BTWT (mean difference = -9.55, 95%CI: -17.89 to -1.41), Shenlingbaizhu powder [SLBZS; odds ratio (OR) = 0.19, 95%CI: 0.08 to 0.39], and Shaoyao decoction (OR = -23.02, 95%CI: -33.64 to -13.14) was effective. Shaoyao decoction was more effective than BTWT (OR = 0.12, 95%CI: 0.03 to 0.39), SLBZS (OR = 0.19, 95%CI: 0.08 to 0. 39), and Xi Lei powder (OR = 0.34, 95%CI: 0.13 to 0.81) in reducing tumor necrosis factor and the recurrence rate of UC.
TCM combined with mesalazine is more effective than mesalazine alone in the treatment of UC.
目前，中药方剂在中国常用于溃疡性结肠炎的辅助治疗。网络荟萃分析作为一种定量且全面的分析方法，能够系统地比较溃疡性结肠炎不同辅助治疗方案的效果，为临床决策提供科学依据。
通过网络荟萃分析评估临床实践中常用中药治疗溃疡性结肠炎（UC）的临床疗效和安全性。
从数据库建立至2022年7月1日，检索用于UC辅助治疗的这些中药方剂的临床随机对照试验。根据Cochrane 5.1标准筛选符合纳入标准的研究，并对文献质量和偏倚风险进行评估。使用ReviewManager（RevMan）5.4评估研究的方法学质量，并构建漏斗图以检验发表偏倚。使用ADDIS 1.16统计软件对治疗措施进行统计分析，并得出各种干预措施的网络关系图和排名图。
本研究共纳入64项涉及5456例UC患者的随机对照试验。使用五种中药方剂辅助治疗UC能够改善患者的临床结局。白头翁汤（BTWT）辅助治疗显示出显著效果[平均差值=36.22，95%置信区间（CI）：7.63至65.七十六]。对于降低UC患者的肿瘤坏死因子，BTWT辅助治疗（平均差值=-9.55，95%CI：-17.89至-1.41）、参苓白术散[SLBZS；比值比（OR）=0.19，95%CI：0.08至0.39]和芍药汤（OR=-23.02，95%CI：-33.64至-13.14）有效。在降低肿瘤坏死因子和UC复发率方面，芍药汤比BTWT（OR=0.12，95%CI：0.03至0.39）、SLBZS（OR=0.19，95%CI：0.08至0.39）和锡类散（OR=0.34，95%CI：0.13至0.81）更有效。
中药联合美沙拉嗪治疗UC比单用美沙拉嗪更有效。
