中医疗法治疗慢性萎缩性胃炎有效性的网状Meta分析  

A Network Meta-Analysis of Efficacies of Traditional Chinese Medicine Therapies for Chronic Atrophic Gastritis

作　　者：王平[1] 谢立群[1] WANG Ping;XIE Li-qun(The First Affiliated Hospital of Nanjing Medical University,Nanjing,JiangSu 210029)

机构地区：[1]南京医科大学第一附属医院,江苏南京210029

出　　处：《按摩与康复医学》2020年第22期1-9,共9页Chinese Manipulation and Rehabilitation Medicine

基　　金：江苏省中医药管理局项目,编号YB2017088;第四批全国中医(临床、基础)优秀人才研修项目,编号:国中医药人教发(2017)24号。

摘　　要：目的:采用网状Meta分析方法评价五种中医基础方加减和西药治疗慢性萎缩性胃炎(CAG)的疗效。方法:计算机检索PubMed、The Cochrane Library(2017年第8期)、EMbase、CNKI、CBM、VIP、WanFang Data数据库中有关中医基础方加减治疗慢性萎缩性胃炎的临床随机对照试验,检索时限均为从建库至2017年8月;由2位研究者独立筛选文献、提取数据评价纳入研究的偏倚风险后,采用Stata14.0和R3.4.2软件进行统计分析。结果:最终纳入34篇RCT,共计3434例慢性萎缩性胃炎患者,涉及6种干预措施,纳入RCT的质量并不高。网状Meta分析结果显示:①五种中药方剂临床疗效均优于西药,益胃汤加减优于六君子汤加减,差异均有统计学意义;根据等级概率图疗效排序依次是:益胃汤加减、健脾通络汤加减、香砂六君子汤加减、半夏泻心汤加减、六君子汤加减、西药。②三种中药HP阴转率优于西药,但三种中药间差异无统计学意义。结论:中药方剂治疗CAG的疗效较西药好,其中益胃汤加减可能是最好的干预措施;基于现有研究的局限性,本研究结论还需开展大量设计合理的RCT予以证实。Objective:A network Meta-analysis was employed to evaluate the efficacies of five traditional Chinese medicine prescriptions and western medicine in the treatment of chronic atrophic gastritis.Method:Clinical randomized controlled trials regarding the treating chronic atrophic gastritis with traditional Chinese medicine in database of PubMed,the Cochrane Library(2017.8),EMbase,CNKI,CBM,VIP and WanFang Data were retrieved.The retrieval time was limited from the build of library to August 2017.Two researchers independently screened the literatures and extracted the data.After evaluating the bias risk of included studies,statistical analysis was carried out using Stata 14.0 and R 3.4.2 software.Result:Eventually 34 RCTs,containing a total of 3434 patients with chronic atrophic gastritis and 6 kinds of interventions were included.The quality of RCT was not high.The results of the network Meta-analysis showed that:(1)The clinical efficacies of 5 traditional Chinese medicine prescriptions were better than that of western medicine.Yiwei decoction was superior to LiuJunZi Decoction,with statistically significant difference.According to the rank probability chart,the curative effect is:Yiwei decoction,Jianpitongluo decoction,Xiangshaliujunzi decoction,Banxiaxiexin decoction,Liujunzi decoction,and western medicine.(2)The HP conversion rates of three kinds of traditional Chinese medicine were superior to western medicine.However,there was no significant difference among the three traditional Chinese medicines.Conclusion:Traditional Chinese medicine prescription was superior to western medicine in the treatment of CAG.Among these,Yiwei decoction may be the best intervention.Based on the limitations of the existing researches,a large number of reasonable RCTs are needed to verify the conclusion of this study.

关 键 词：慢性萎缩性胃炎 中医疗法 中药 疗效评价 网状Meta分析 

分 类 号：R259[医药卫生—中西医结合]