小柴胡汤联合西药治疗胆汁反流性胃炎疗效比较的系统评价  

System Evaluation of Comparisons for Curative Effects of Xiaochaihu Decoction and Western Medicine for the Treatment of Bile Reflux Gastritis

作　　者：薛晓焕[1] 宋俊生[1] 高岑[1] 熊俊[2] 孙宇田[1] 勾晓晨[1] 

机构地区：[1]天津中医药大学,天津300193 [2]广州中医药大学,广东广州510405

出　　处：《中医学报》2013年第4期495-500,共6页Acta Chinese Medicine

基　　金：国家自然科学基金资助项目(编号:30973726)

摘　　要：目的:比较小柴胡汤联合西药治疗胆汁反流性胃炎的有效性和安全性。方法:计算机检索中国生物医学文献数据库(1979年-2011年)、中国知网(1979年-2011年)、维普数据库(1989年-2011年)和万方数字化期刊群(1998年-2011年)。辅以手工检索天津中医药大学图书馆过刊资料库。收集小柴胡汤和西药比较治疗胆汁反流性胃炎的临床随机对照试验,由两名评价者独立提取资料并按照Cochrane Review Handbook 5.1.0进行质量评估。统计学分析采用RevMan5.1.6软件。结果:共纳入14篇临床随机对照试验,共有1 242例。Meta分析结果显示:①胃镜下胆汁反流消失率:小柴胡汤加减与铝镁加比较:[RR=1.57,95%CI(1.20,2.05)],差异有统计学意义;小柴胡汤加减与吗叮啉比较:[RR=1.20,95%CI(0.98,1.48)],差异无统计学意义。②胃镜下炎症改善率:小柴胡汤加减与铝镁加比较:[RR=1.48,95%CI(1.12,1.95)],差异有统计学意义;小柴胡汤加减与吗叮啉比较:[RR=1.19,95%CI(0.97,1.46)],差异无统计学意义。④临床有效率:小柴胡汤加减与吗叮啉+法莫替丁比较:[RR=1.31,95%CI(1.11,1.56)],差异有统计学意义;小柴胡汤加减与吗叮啉+雷尼替丁比较:[RR=1.20,95%CI(1.06,1.37)],差异有统计学意义;小柴胡汤加减与吗叮啉+硫糖铝比较:[RR=1.30,95%CI(1.17,1.44)],差异有统计学意义。结论:小柴胡汤加减治疗胆汁反流性胃炎在临床有效率、胃镜下表现等方面有较好的疗效,但由于纳入试验存在诸多方法学问题,其有效性尚需要更多高质量的随机双盲对照试验的进一步证实。Objective：To compare the efficacy and safety of Xiaochaihu Decoction and western medicine in the treatment of bile reflux gastritis.Methods：CBM（1979 to 2011）,CNKI（1979 to 2011）,VIP（1989 to 2011）and WanFang digital periodical group were searched by computer,with manual retrieval Tianjin University of Traditional Chinese Medicine library back issue database.Clinical randomized controlled trials of the comparisons of Xiaochaihu Decoction and western medicine for the treatment of bile reflux gastritis were collected.Datas were extracted by two independent valuers,and then quality assessments were carried out according to the Cochrane Review Handbook 5.1.0.RevMan5.1.6 software was used for statistical analysis.Results：Article 14 clinical randomized controlled trials involved 1242 cases were included.Meta analysis results showed that ① Comparision of the bile reflux disappear rate under gastroscope in modified Xiaochaihu Decoction and the almagate group showed that difference had statistical significance [RR= 1.57,95%CI（1.20,2.05）],but when Xiaochaihu Decoction was compared with motilium group,the difference was not statistically significant.[RR=1.20,95%CI（0.98,1.48）]② Comparision of the improvement rate of inflammation under gastroscope in modified Radix Bupleuri Decoction and the almagate group showed that there was statistical difference[RR=1.48,95%CI（1.12,1.95）,but when Xiaochaihu Decoction was compared with motilium group,the difference had no statistics significance[RR= 1.19,95% CI（0.97,1.46）.③ For clinical effective rate,there were statistical differences when Xiaochaihu Decoction was compared with the combination usage of motilium and famotidine[RR=1.31,95%CI（1.11,1.56）],the combination of motilium and ranitidine[RR=1.20,95%CI（1.06,1.37）],and the combination of motilium and sucralfate[RR=1.30,95%CI（1.17,1.44）].Conclusion：The application of Xiaochaihu Decoction for the treatment of bile reflux gastritis has good curative effect in clinical efficiency,manifest

关 键 词：胆汁反流性胃炎 小柴胡汤 铝镁加 吗叮啉 法莫替丁 随机对照试验 系统评价 

分 类 号：R222[医药卫生—中医基础理论]