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中药作为难治性胃食管反流病辅助治疗的积极作用：一项系统评价和网状Meta分析

The positive role of Chinese herbal medicine as an adjunctive therapy for refractory gastroesophageal reflux disease: A systematic review and network meta-analysis.

作者信息

Zhang Ruiting, Yang Zhenyu, Pan Xiangbin, Liu Yingzhe, Huang Qiusi, Song Zexi, Yao Qianqian, Li Dongxia, Zhang Yuan

机构信息

Heilongjiang University of Chinese Medicine, Harbin, China.

The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China.

出版信息

Medicine (Baltimore). 2025 May 23;104(21):e42565. doi: 10.1097/MD.0000000000042565.

DOI:10.1097/MD.0000000000042565
PMID:40419902
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12113975/
Abstract

BACKGROUND: Proton pump inhibitors are currently the primary treatment option for refractory gastroesophageal reflux disease (rGERD), yet they have limitations, including poor efficacy and potential adverse events. Chinese herbal medicine (CHM) may offer an effective and safe adjunctive therapy. METHODS: This network meta-analysis investigate the adjunctive therapeutic effect and safety of CHM on rGERD. Randomized controlled trials (RCTs) of CHM combined with conventional Western medicine in the treatment of rGERD added to 8 online databases from its inception to January 2024 were systematically searched. Review Manager 5.3 and and Stata 14.0 software were used to conduct pairwise meta-analysis and network meta-analysis of RCTs that met the inclusion criteria. In addition, the methodological quality of RCTs was analyzed using the Cochrane Collaboration Risk of Bias ROB 2.0 assessment tool. This study was registered in PROSPERO (International Prospective Register of Systematic Reviews) (CRD42024532264). RESULTS: This study included a total of 19 RCTs, comparing 16 CHMs. Pairwise meta-analysis indicated that CHM combined with conventional Western medicine outperformed the latter in terms of overall clinical efficacy, recurrence rate, and symptom improvement. Network meta-analysis suggested that Shugan Jieyu Capsule may significantly enhance overall clinical efficacy, while Buzhongyiqi Granules may significantly reduce the recurrence rate, Sanji Powders may significantly improve symptoms of acid reflux, Shugan Jieyu Capsule may significantly improve symptoms of heartburn, and Shugan Jianpi Hewei Decoction may significantly improve symptoms of esophageal chest pain, Qingweishu Granules may significantly improve the frequency scale for the symptoms of GERD score. No serious adverse events were reported in any of the RCTs. CONCLUSION: The findings of this study indicate that CHM offers a positive adjunctive therapeutic benefit for rGERD; however, it is imperative to enhance the quality of future RCTs to validate these preliminary findings.

摘要

背景：质子泵抑制剂目前是难治性胃食管反流病（rGERD）的主要治疗选择，但它们存在局限性，包括疗效不佳和潜在的不良事件。中药可能提供一种有效且安全的辅助治疗方法。 方法：本网络荟萃分析研究了中药对rGERD的辅助治疗效果和安全性。系统检索了从建库至2024年1月的8个在线数据库中关于中药联合传统西药治疗rGERD的随机对照试验（RCT）。使用Review Manager 5.3和Stata 14.0软件对符合纳入标准的RCT进行成对荟萃分析和网络荟萃分析。此外，使用Cochrane协作偏倚风险ROB 2.0评估工具分析RCT的方法学质量。本研究已在PROSPERO（国际系统评价前瞻性注册库）注册（CRD42024532264）。 结果：本研究共纳入19项RCT，比较了16种中药。成对荟萃分析表明，中药联合传统西药在总体临床疗效、复发率和症状改善方面优于后者。网络荟萃分析表明，疏肝解郁胶囊可能显著提高总体临床疗效，补中益气颗粒可能显著降低复发率，散剂可能显著改善反酸症状，疏肝解郁胶囊可能显著改善烧心症状，疏肝健脾和胃汤可能显著改善食管胸痛症状，清胃舒颗粒可能显著改善GERD症状频率量表评分。所有RCT均未报告严重不良事件。 结论：本研究结果表明，中药对rGERD具有积极的辅助治疗益处；然而，必须提高未来RCT的质量以验证这些初步发现。

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本文引用的文献

[1]
Updates to the modern diagnosis of GERD: Lyon consensus 2.0.

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[2]
Association Between Anxiety/Depression and Gastroesophageal Reflux: A Systematic Review and Meta-Analysis.

Am J Gastroenterol. 2023-12-1

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Exploring the Potential Molecular Mechanism of the Shugan Jieyu Capsule in the Treatment of Depression through Network Pharmacology, Molecular Docking, and Molecular Dynamics Simulation.

Curr Comput Aided Drug Des. 2024

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Yueju volatile oil plays an integral role in the antidepressant effect by up-regulating ERK/AKT-mediated GLT-1 expression to clear glutamate.

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A review of the botany, traditional uses, phytochemistry, and pharmacology of the Flos Inulae.

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Ann Intern Med. 2021-7

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