College of Graduate Studies, Jiangxi University of Chinese Medicine, Nanchang, China.
Academician Workstation, Jiangxi University of Chinese Medicine, Nanchang, China.
Complement Med Res. 2024;31(5):461-476. doi: 10.1159/000540793. Epub 2024 Aug 13.
Infectious diarrhea (ID) is a highly prevalent disease worldwide that poses a substantial risk to human well-being. In China, numerous clinical studies have investigated the efficacy of Gegen Qinlian decoction (GGQLD) in treating ID. However, there is a need for additional rigorous and evidence-based medical research to enhance physicians' confidence in their prescribing practices.
Seven Chinese and English databases were systematically searched. The Cochrane Risk of Bias tool was used to assess the quality of the included studies. Meta-analysis was conducted using RevMan 5.3, and Stata 16.0 was used for the sensitivity analysis. Trial sequential analysis was performed using TSA v0.9, and GRADEprofiler was utilized to evaluate the quality of evidence.
A total of 12 randomized controlled trials (RCTs) involving 1,240 patients were included. The meta-analysis demonstrated that the combination of GGQLD with conventional Western medicine had better effects on clinical efficacy (relative risk [RR] = 1.15, 95% confidence interval [CI] [1.10, 1.20]), duration of diarrhea symptoms (weighted mean difference [WMD] = -10.96, 95% CI [-11.97, -9.96]), duration of abdominal pain symptoms (WMD = -12.01, 95% CI [-14.12, -9.90]), duration of fever symptoms (WMD = -11.91, 95% CI [-13.39, -10.43]), interleukin-6 levels (WMD = -113.59, 95% CI [-113.03, -108.14]), and tumor necrosis factor-α levels (WMD = -62.18, 95% CI [-65.25, -59.11]) and that no significant adverse reactions occurred (RR = 0.45, 95% CI [0.10, 1.97]). The sample size of the included studies reached the expected size. The quality of evidence for outcome indicators was rated as low or very low.
The combination of GGQLD with conventional Western medicine demonstrates promising efficacy and safety in treating ID. Nonetheless, more high-quality RCTs are required to confirm this conclusion.
传染性腹泻（ID）是一种全球高发疾病，对人类健康构成重大威胁。在中国，许多临床研究已经探讨了葛根芩连汤（GGQLD）治疗 ID 的疗效。然而，需要进行更多严格和基于证据的医学研究，以增强医生对其处方实践的信心。
系统检索了七个中文和英文数据库。使用 Cochrane 偏倚风险工具评估纳入研究的质量。使用 RevMan 5.3 进行荟萃分析，使用 Stata 16.0 进行敏感性分析。使用 TSA v0.9 进行试验序贯分析，使用 GRADEprofiler 评估证据质量。
共纳入 12 项随机对照试验（RCT），涉及 1240 名患者。荟萃分析表明，GGQLD 联合常规西药治疗在临床疗效（相对风险 [RR] = 1.15，95%置信区间 [CI] [1.10, 1.20]）、腹泻症状持续时间（加权均数差 [WMD] = -10.96，95% CI [-11.97, -9.96]）、腹痛症状持续时间（WMD = -12.01，95% CI [-14.12, -9.90]）、发热症状持续时间（WMD = -11.91，95% CI [-13.39, -10.43]）、白细胞介素-6 水平（WMD = -113.59，95% CI [-113.03, -108.14]）和肿瘤坏死因子-α 水平（WMD = -62.18，95% CI [-65.25, -59.11]）方面均有更好的效果，且未发生明显不良反应（RR = 0.45，95% CI [0.10, 1.97]）。纳入研究的样本量达到预期规模。结局指标的证据质量被评为低或极低。
GGQLD 联合常规西药治疗 ID 具有较好的疗效和安全性。然而，需要更多高质量的 RCT 来证实这一结论。
