中成药联合西药治疗慢性萎缩性胃炎的网状Meta分析  

Network Meta-Analysis of Chinese Patent Medicines Combined with Western Medicines in the Treatment of Chronic Atrophic Gastritis

作　　者：马玉景 郎晓猛[3,4] 康欣 刘晓萌[1,2] 刘建平 MA Yujing;LANG Xiaomeng;KANG Xin;LIU Xiaomeng;LIU Jianping(Hebei College of Traditional Chinese Medicine,Shijiazhuang 050091;The First Affiliated Hospital of Hebei College of Traditional Chinese Medicine,Shijiazhuang 050011;Hebei Provincial Hospital of Traditional Chinese Medicine,Shijiazhuang 050011;Hebei Provincial Key Laboratory of Gastroenterology Research of Integrated Traditional Chinese and Western Medicine,Shijiazhuang 050011)

机构地区：[1]河北中医学院,石家庄050091 [2]河北中医学院第一附属医院,石家庄050011 [3]河北省中医院,石家庄050011 [4]河北省中西医结合胃肠病研究重点实验室,石家庄050011

出　　处：《中药药理与临床》2023年第4期79-86,共8页Pharmacology and Clinics of Chinese Materia Medica

基　　金：国家中医临床研究基地建设项目(国中医药办科技函[2018]18);河北省自然基金资助项目(编号:H2019423077);政府资助临床医学人才培养项目(编号:2019061444);河北省中医药管理局科研项目(编号:2018028)。

摘　　要：目的:采用网状Meta分析的方法评价不同中成药联合西药治疗慢性萎缩性胃炎(CAG)的疗效及安全性。方法:计算机检索相关数据库,筛选各数据库建库至2021年1月1日所发表的不同中成药治疗CAG的随机对照试验(RCT),按照“Cochrane风险偏倚评估工具”进行质量评价,应用Stata 14.0进行数据分析。结果:最终纳入32个RCTs,涉及6种口服中成药,3 962例患者。网状Meta分析结果显示:在提高临床疗效方面排序为:摩罗丹>气滞胃痛颗粒>胃苏颗粒>枳术宽中胶囊>香砂养胃丸>胃复春片分别联用常规西药;在提高胃镜疗效方面排序为:摩罗丹>香砂养胃丸>胃复春片>枳术宽中胶囊>气滞胃痛颗粒分别联用常规西药;在Hp根除率方面排序为:枳术宽中胶囊>气滞胃痛颗粒>摩罗丹颗粒分别联用常规西药;用药安全性方面:总体上治疗组相较于对照组不良反应发生的频次、类型明显下降,所有研究均未因不良反应事件而停药。结论:本研究初步评价了六种中成药在改善CAG结局指标方面的疗效及排序情况,但由于纳入研究的局限性,方法学质量普遍不高,应谨慎选择用药,未来仍需开展多中心、大样本、高质量的RCT予以验证。Objective:To evaluate the efficacy and safety of different Chinese patent medicines combined with western medicine in the treatment of chronic atrophic gastritis(CAG)through network meta-analysis.Methods:The relevant papers were searched against CNKI,Wanfang Data,VIP,PubMed,EMbase,and The Cochrane Library from the establishment of database to January 1,2021.According to the inclusion and exclusion criteria,two researchers independently screened out the randomized controlled trials(RCTs)using different Chinese patent medicines combined with conventional Western medicine for the treatment of CAG and then conducted quality evaluation in accordance with the Cochrane Collaboration’s tool for assessing risk of bias.Stata 14.0 was used for data analysis.Results:Finally,32 RCTs were included,involving 6 oral Chinese patent medicines and 3962 patients.The network meta-analysis results showed that in terms of improving clinical efficacy,Chinese patent medicines followed the order of Moluodan(摩罗丹)>Qizhiweitong(气滞胃痛)Granules>Weisu(胃苏)Granules>Zhizhukuanzhong(枳术宽中)Capsules>Xiangshayangwei(香砂养胃)Pills>Weifuchun(胃复春)Tablets.In terms of improving the efficacy of gastroscopy,the order of Chinese patent medicines was Moluodan>Xiangshayangwei Pills>Weifuchun Tablets>Zhizhukuanzhong Capsules>Qizhiweitong Granules.For eradicating Helicobacter pylori(Hp),Chinese patent medicines followed the trend of Zhizhukuanzhong Capsules>Qizhiweitong Granules>Moluodan.In terms of safety,the frequency and types of adverse reactions in the treatment group generally decreased significantly compared with those of the control group,and none RCTs stopped the medication due to adverse events.Conclusion:This study preliminarily evaluated the efficacy of different Chinese patent medicines combined with western medicine in improving the indicators of CAG treatment.However,since the included RCTs generally did not have high methodological quality,the medicines should be selected with caution.It is still necessary to c

关 键 词：中成药 慢性萎缩性胃炎 网状Meta分析 随机对照试验 

分 类 号：R573.32[医药卫生—消化系统]