中药联合三联疗法治疗Hp阳性消化性溃疡临床疗效与安全性的Meta分析  

Meta-anaysis on traditional Chinese medicine combined with triple therapy in treating helicobacter pylori positive peptic ulcer

作　　者：张彧[1] 吴东升[1] 徐寅[2] 肖波 喻斌[2] ZHANG Yu;WU Dong-sheng;XU Yin;XIAO Bo;YU Bin(Hunan University of Chinese Medicine,Changsha 410208,China;Department of Digestive,First Affiliated Hospital of Hunan University of Traditional Chinese Medicine,Changsha 410007,China)

机构地区：[1]湖南中医药大学,湖南长沙410208 [2]湖南中医药大学第一附属医院脾胃病科,湖南长沙410007

出　　处：《中国中西医结合消化杂志》2019年第9期653-661,共9页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：湖南省科技创新项目(No:2018SK51201);湖南省教育厅重点项目(No:17A158);湖南中医药大学中医学国内一流建设学科(2018年—2020年)

摘　　要：[目的]运用循证医学方法系统性评价中药联合三联疗法治疗Hp阳性消化性溃疡的有效性和安全性。[方法]检索Web of science、EM-BASE、PubMed、Cochrane library、VIP、CNKI、WanFang Data、CBM数据库,收集相关的随机对照设计试验(RCT),筛选文献、提取资料,评价文献质量,并采用RevMan5.3软件进行Meta分析。[结果]共纳入41篇文献,共4 493例。Meta分析结果显示:与对照组三联疗法比较,中药联合三联疗法的Hp根除率[OR=2.62,95%CI(2.14,3.22)],6个月内Hp复发率[OR=0.32,95%CI(0.16,0.63)],1年内Hp复发率[OR=0.26,95%CI(0.12,0.57)],临床总有效率[OR=5.35,95%CI(4.00,7.16)],胃镜溃疡疗效总有效率[OR=3.62,95%CI(2.56,5.11)],6个月内溃疡复发率[OR=0.18,95%CI(0.07,0.48)],1年内溃疡复发率[OR=0.26,95%CI(0.15,0.43)],及不良反应发生率[OR=0.31,95%CI(0.22,0.45)]的差异均有统计学意义(P<0.01)。[结论]与三联疗法比较,中药联合三联疗法有效、安全,能提高Hp根除率与消化性溃疡的临床疗效,降低Hp复发率和溃疡复发率,远期疗效更佳,并减少不良反应的发生。敏感性分析结果提示发表性偏倚影响不大,结果比较稳定,结论有效。[Objective]To systematically evaluate the efficacy and safety of traditional Chinese medicine combined with triple therapy in the treatment of Hp-positive peptic ulcer with evidence-based medicine.[Methods]Search Web of science,EM-BASE,PubMed,Cochrane library,VIP,CNKI,WanFang Data,CBM database,collect relevant randomized controlled design experiments,screen literature,extract data,evaluate literature quality,and use RevMan5.3 software.Conduct a meta-analysis.[Results]A total of 41 articles were included,a total of 4493 cases.Compared with the control group,the Hp eradication rate of traditional Chinese medicine combined with triple therapy[OR=2.62,95%CI(2.14,3.22)],Hp recurrence rate within 6 months[OR=0.32,95%CI(0.16,0.63)],Hp recurrence rate within 1 year[OR=0.26,95%CI(0.12,0.57)],total clinical effective rate[OR=5.35,95%CI(4.00,7.16)],curative effect of gastroscopic ulcer The total effective rate[OR=3.62,95%CI(2.56,5.11)],ulcer recurrence rate within 6 months[OR=0.18,95%CI(0.07,0.48)],ulcer recurrence rate within 1 year[OR=0.26,95%CI(0.15,0.43)],curative effect of gastroscopic ulcer,the total effective rate[OR=3.62,95%CI(2.56,5.11)],ulcer recurrence rate within 6 months[OR=0.18,95%CI(0.07,0.48)],ulcer recurrence rate within 1 year[OR=0.26,95%CI(0.15,0.43)] and the incidence of adverse reactions[OR=0.31,95%CI(0.22,0.45)] were statistically significant(P<0.01),as the Meta-analysis showed.[Conclusion]Compared with triple therapy,traditional Chinese medicine combined with triple therapy can improve the clinical efficacy of Hp eradication rate and peptic ulcer,reduce Hp recurrence rate and ulcer recurrence rate,improve long-term efficacy and reduce adverse reactions.It’s safe and effective.Sensitivity analysis showed that the publication bias had little effect,the results were stable and the conclusions were valid.

关 键 词：消化性溃疡 幽门螺杆菌 中药 三联疗法 META分析 

分 类 号：R573[医药卫生—消化系统]