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中西医结合治疗胆结石的疗效与安全性。

Efficacy and safety of combining Chinese medicine with Western medicine for gallstone treatment.

作者信息

Jiang Tianpei, Ouyang Wensi, Yao Wenjie, Dong Jiantong, Nie Jinna

机构信息

Changchun University of Chinese Medicine, Changchun Province, China.

出版信息

Medicine (Baltimore). 2025 Jun 27;104(26):e43065. doi: 10.1097/MD.0000000000043065.

Abstract

BACKGROUND

Background gallstones are a common and multiple disease, with a high global prevalence, complications such as cholecystitis, pancreatitis, and even increased risk of cancer. Oral Chinese medicine, as the main treatment method of traditional Chinese medicine, is widely used in the treatment of gallstones. This study aimed to evaluate the efficacy and safety of Chinese medicine combined with Western medicine for the treatment of gallstones.

METHODS

We searched PubMed, Web of Science, Embase, Cochrane Library, Chinese National Knowledge Infrastructure, WanFang, Chinese Scientific Journal Database (VIP), and Chinese BioMedical Literature Database. The search time was set to be up to July 2, 2024. Data analysis using Revman 5.3 software. The protocol is registered in the PROSPERO database (CRD42024567327).

RESULTS

Ultimately, 912 patients from 8 randomized controlled trials were included. The meta-analysis results of traditional Chinese medicine combined with Western medicine versus Western medicine were as follows: imaging examination (standardized mean difference, SMD = -1.51, 95% confidence interval [CI] (-2.36, -0.65), P < .001), total cholesterol level (SMD = -2.14, 95% CI (-3.61, -0.67), P = .004), total bile acid level (SMD = -0.97, 95% CI (-3.36, -1.42), P = .043), traditional Chinese medicine symptom scores (SMD = -1.88, 95% CI (-3.16, -0.60), P = .004), occurrence of adverse reaction (odds ratio = 0.51, 95% CI (0.21, 1.24), P = .14).

CONCLUSION

The curative effect of Chinese medicine combined with Western medicine in the treatment of gallstones is better than that of Western medicine and is safety. Due to the limited quantity and quality of the included literature, more literature on double-blind randomized controlled trials with large samples is needed in the later stage to verify this conclusion.

摘要

背景

胆囊结石是一种常见的多发性疾病,全球患病率较高,会引发胆囊炎、胰腺炎等并发症,甚至增加患癌风险。口服中药作为中医的主要治疗方法,在胆囊结石治疗中被广泛应用。本研究旨在评估中西医结合治疗胆囊结石的疗效和安全性。

方法

我们检索了PubMed、Web of Science、Embase、Cochrane图书馆、中国知网、万方、维普和中国生物医学文献数据库。检索时间设定截至2024年7月2日。使用Revman 5.3软件进行数据分析。该方案已在PROSPERO数据库(CRD42024567327)中注册。

结果

最终,纳入了8项随机对照试验中的912例患者。中西医结合与单纯西医治疗的荟萃分析结果如下:影像学检查(标准化均数差,SMD = -1.51,95%置信区间[CI](-2.36,-0.65),P <.001)、总胆固醇水平(SMD = -2.14,95% CI(-3.61,-0.67),P =.004)、总胆汁酸水平(SMD = -0.97,95% CI(-3.36,-1.42),P =.043)、中医症状评分(SMD = -1.88,95% CI(-3.16,-0.60),P =.004)、不良反应发生率(比值比 = 0.51,95% CI(0.21,1.24),P =.14)。

结论

中西医结合治疗胆囊结石的疗效优于单纯西医治疗且具有安全性。由于纳入文献的数量和质量有限,后期需要更多大样本双盲随机对照试验文献来验证这一结论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d58b/12212820/b1fd4a43a7f6/medi-104-e43065-g001.jpg

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