中医药治疗慢性萎缩性胃炎伴异型增生疗效的系统评价  

The Treatment of Chronic Atrophic Gastritis with Dysplasia by Chinese Medicine:A Systematic Review

作　　者：魏霞[1] 钦丹萍[2] 

机构地区：[1]杭州师范大学附属医院,杭州310015 [2]浙江中医药大学附属第一医院

出　　处：《浙江中医药大学学报》2013年第7期864-869,共6页Journal of Zhejiang Chinese Medical University

摘　　要：[目的]分析比较中医药治疗与西医治疗慢性萎缩性胃炎(chronic atrophic gastritis,CAG)伴异型增生的疗效和安全性。[方法]检索PubMed、Cochrane图书馆、万方和中国期刊网中的随机对照试验(randomized controlled trial,RCT)文献,根据纳入标准将论文纳入研究并提取纳入研究的特征信息,按治疗方法分为西医对照组和中医药治疗组。采用RevMan5.0软件进行数据分析,先后进行异质性检验,根据检验结果选择相应的效应模型。然后进行敏感性分析,并以漏斗图、Egger回归方程评定有无发表偏倚。[结果]6篇RCT文献纳入本研究,共有632例CAG伴异型增生的患者。研究表明,中医药治疗组的临床症状、胃镜改善及病理改善情况的总显效率及总有效率的优势比(OR)均高于西医对照组;漏斗图基本呈现下宽上窄、左右对称的倒漏斗形,Egger线性回归常数项检验表明无发表偏倚。[结论]中医药治疗CAG伴异型增生能有效改善本病临床症状、胃镜及病理情况,疗效优于西医对照组。[Objective] Through a meta-analysis to compare the effectiveness and safety of traditional Chinese medicine and western medicine in the treat ment of chronic atrophic gastritis（CAG） with dysplasia.[Methods] Randomized clinical trials（RCTs） which compared traditional Chinese medicine and western medicine for chronic atrophic gastritis with dysplasia in PubMed,Cochrane library,WanFang and CNKI were searched.The patients which were analyzed were divided into two groups： western medicine and traditional Chinese medicine.Statistical heterogeneity between trials was evaluated by RevMan5.0.Heterogeneity of the included articles was tested and used to select proper effective model for calculation.Publication bias was investigated through visual inspection of funnel plots and Egger’s regression model.[Results] 6 RCTs including 632 patients were analyzed.The total odd ratios（OR） of clinical symptoms,gastroscope symptoms,pathological symptoms by traditional Chinese medicine were higher than western medicine,the OR values were 3.40（95%CI：2.18～5.31,P0.01）,4.14（95%CI：2.37～7.20,P0.01）,2.94（95%CI：1.77～4.90,P0.01）,3.71（95%CI：2.29～6.02,P0.01）,4.41（95%CI：2.75～ 7.07,P0.01）,5.21（95%CI：3.65～7.43,P0.01）.Inspection of the funnel plots for all outcome measures did not reveal evidence of publication bias（P= 0.81,0.41,0.29,0.88,0.44,0.82,respectively）.[Conclusions] The treatment of chronic atrophic gastritis with dysplasia by traditional Chinese medicine can improve the excellent response rate,overall response rate of clinical symptoms,gastroscope symptoms,pathological symptoms better than its purely western medicine treatment efficacy.

关 键 词：CAG 异型增生 中医药 疗效META分析 

分 类 号：R256.3[医药卫生—中医内科学]