Ren Baoping, Zhong Meiqi, Yu Chang, Xiong Meng, Zhou Shunhua, Gao Qing, Wang Xiaojuan, Peng Qinghua, Zeng Meiyan, Xie Mengzhou, Song Houpan
Hunan Provincial Key Laboratory of Traditional Chinese Medicine Diagnostics, Hunan University of Chinese Medicine, Changsha, Hunan Province, China.
College of Traditional Chinese Medicine, Hunan University of Chinese Medicine, Changsha, Hunan Province, China.
Medicine (Baltimore). 2025 Mar 7;104(10):e41690. doi: 10.1097/MD.0000000000041690.
The study aimed to conduct a network meta-analysis of randomized controlled trials (RCTs) to examine the effectiveness and safety of traditional Chinese patent medicine (TCPM), either used alone or combined with conventional treatment (CT) of chemical drugs, for treating chronic atrophic gastritis (CAG).
We searched the literature from database creation to December 2023; our primary endpoint was clinical response rate. Secondary outcome measures were the inhibition rate of Helicobacter pylori and clinical symptom score, including pain and noisy scores for the stomach, score for belch and acid reflux, score for the bitter taste and the dry throat, and safety according to total adverse events. Data analyzed using RevMan 5.3, R (v4.0.2), and Stata SE 15.0. Mean differences (MDs) for continuous outcomes and odds ratios (ORs) for dichotomous outcomes and drug ranking by P-score. Network meta-analysis presented as forest plot and league table. Results reported as MDs/ORs with 95% confidence interval (CI).
Our analysis comprised 49 RCTs with 5218 patients. Compared to using CT alone, all TCPMs + CT performed better in improving clinical response rate. The Weifuchun tablet (WFCT) inhibition rate (OR = 9.05; 95% CI = 1.89-43.34; P-score = .92) was relatively high, but only 1 RCT supported this result. WFCT + CT (OR = 2.94; 95% CI = 1.97-4.39; P-score = .57), Qizhiweitong granule (QZWTG) + CT (OR = 2.91; 95% CI = 1.07-7.89; P-score = .55), and Moluodan (MLD) + CT (OR = 2.44; 95% CI = 1.37-4.36; P-score = .43) had certain advantages in inhibiting H pylori compared to using CT alone. Compared with CT, Weisu tablet (WST) + CT (OR = 0.21; 95% CI = 0.05-0.89; P-score = .24) and Xiangshayangwei pill (XSYWP) + CT (OR = 0.41; 95% CI = 0.18-0.92; P-score = .44) were drugs that were less likely to cause adverse reactions.
Our results demonstrate that, compared to using CT alone, TCPMs combined with CT can improve the clinical response rate in the treatment of CAG. Additionally, some TCPMs combined with CT can enhance the H pylori inhibition rate. WST + CT and XSYWP + CT can even reduce the occurrence of adverse reactions.
本研究旨在对随机对照试验（RCT）进行网状Meta分析，以检验中成药单独使用或与化学药物常规治疗（CT）联合使用治疗慢性萎缩性胃炎（CAG）的有效性和安全性。
我们检索了从数据库创建至2023年12月的文献；我们的主要终点是临床缓解率。次要结局指标是幽门螺杆菌抑制率和临床症状评分，包括胃脘疼痛和嘈杂评分、嗳气和反酸评分、口苦和咽干评分，以及根据总不良事件评估的安全性。使用RevMan 5.3、R（v4.0.2）和Stata SE 15.0进行数据分析。连续结局的均值差（MDs）和二分结局的比值比（ORs）以及按P值评分的药物排名。网状Meta分析以森林图和联赛表形式呈现。结果报告为MDs/ORs及95%置信区间（CI）。
我们的分析纳入了49项RCT，共5218例患者。与单独使用CT相比，所有中成药+CT在提高临床缓解率方面表现更好。胃复春片（WFCT）的抑制率（OR = 9.05；95%CI = 1.89 - 43.34；P值评分 = 0.92）相对较高，但仅有1项RCT支持该结果。WFCT + CT（OR = 2.94；95%CI = 1.97 - 4.39；P值评分 = 0.57）、气滞胃痛颗粒（QZWTG）+ CT（OR = 2.91；95%CI = 1.07 - 7.89；P值评分 = 0.55）和摩罗丹（MLD）+ CT（OR = 2.44；95%CI = 1.37 - 4.36；P值评分 = 0.43）与单独使用CT相比，在抑制幽门螺杆菌方面具有一定优势。与CT相比，维U颠茄铝片（WST）+ CT（OR = 0.21；95%CI = 0.05 - 0.89；P值评分 = 0.24）和香砂养胃丸（XSYWP）+ CT（OR = 0.41；95%CI = 0.18 - 0.92；P值评分 = 0.44）是较不易引起不良反应的药物。
我们的结果表明，与单独使用CT相比，中成药与CT联合使用可提高CAG治疗的临床缓解率。此外，一些中成药与CT联合使用可提高幽门螺杆菌抑制率。WST + CT和XSYWP + CT甚至可减少不良反应的发生。
