清热祛湿法治疗慢性萎缩性胃炎的Meta分析  

A Meta-analysis of the treatment of chronic atrophic gastritis by clearing heat and dispelling dampness

作　　者：尹静雯 朱永苹[1] 吴月霞 YIN Jingwen;ZHU Yongping;WU Yuexia

机构地区：[1]广西中医药大学附属瑞康医院,广西南宁530000

出　　处：《中医临床研究》2023年第18期8-13,共6页Clinical Journal Of Chinese Medicine

基　　金：广西壮族自治区中医药管理局自筹课题(Z20210250);广西壮族自治区中医药管理局自筹课题(Z20210121);广西中医药大学研究生教育创新计划项目(YCXJ2021095)。

摘　　要：目的:系统评价清热祛湿法联合常规西药治疗慢性萎缩性胃炎的有效性及安全性。方法:在中文数据库(中国知网、维普数据库、万方数据库)和英文数据库(EMbase、PubMed、Cochrane Library)中,检索采用清热祛湿法对慢性萎缩性胃炎进行治疗的随机对照试验,检索、筛选和提取建库至2022年1月1日期间相关研究数据,经过纳入标准和排除标准的筛选以及NoteExpress的查重功能确定最终纳入的文献,然后应用RevMan 5.3软件对纳入文献的各项指标采取Meta分析。结果:最终纳入文献16篇,共计1340例患者。Meta分析结果显示清热祛湿法联合西药治疗对比单纯西医治疗具有显见优势,可有效提高临床总有效率[相对危险度(Risk Ratio,RR)=1.25,95%置信区间(Confidence Interval,CI)(1.18,1.32),P<0.00001];明显改善胃镜疗效[RR=1.20,95%CI(1.06,1.37),P<0.00001];显著降低各中医证候疗效积分:胃脘胀满[均数差(Mean Difference,MD)=–0.45,95%CI(–0.60,–0.30),P<0.00001],胃脘灼热[MD=–0.33,95%CI(–0.44,–0.22),P<0.00001],恶心呕吐[MD=–0.35,95%CI(–0.46~–0.24),P<0.0001],口干口苦[MD=–0.39,95%CI(–0.53~–0.26),P<0.0001];并且不增加不良反应发生率[RR=0.56,95%CI(0.19,1.60),P=0.28]。结论:清热祛湿法联合西药治疗慢性萎缩性胃炎在提高患者临床治疗有效率,改善患者胃镜疗效和临床症状等方面效果优于单纯西医治疗,且不增加患者不良反应发生率,但是今后仍需更多高质量、大样本量的随机对照试验研究进一步验证支持。Objective:To systematically evaluate the efficacy and safety of clearing heat and dispelling dampness combined with conventional Western medicine in the treatment of chronic atrophic gastritis.Methods:In Chinese databases(CNKI,VIP,Wanfang)and English databases(EMbase,PubMed,Cochrane Library),randomized controlled trials of clearing heat and dispelling dampness for chronic atrophic gastritis were searched to retrieve,screen and extract relevant research data from the establishment of the database to January 1,2022.After screening by inclusion criteria and exclusion criteria as well as the recheck function of NoteExpress,the finally included studies were determined.Then,meta-analysis was performed on various indicators of the included literatures by RevMan 5.3 software.Results:Finally,16 studies with a total of 1340 patients were included.Meta-analysis showed that the combination of clearing heat and dispelling dampness therapy with Western medicine had obvious advantages compared with Western medicine alone,and could effectively improve the total clinical effective rate(RR=1.25,95%CI[1.18,1.32],P<0.00001).The effect of gastroscopy was significantly improved(RR=1.20,95%CI[1.06,1.37],P<0.00001).It significantly reduced the efficacy score of each TCM syndrome:epigastric fullness(MD=–0.45,95%CI[–0.60,–0.30],P<0.00001),epigastric burning(MD=–0.33,95%CI[–0.44,–0.22],P<0.00001),nausea and vomiting(MD=–0.35,95%CI[–0.46,–0.24],P<0.0001),dry and bitter mouth(MD=–0.39,95%CI[–0.53,–0.26],P<0.0001).And it did not increase the incidence of adverse reactions(RR=0.56,95%CI[0.19,1.60],P=0.28).Conclusion:The combination of clearing heat and dispelling dampness therapy with Western medicine is superior to Western medicine in improving the clinical efficiency of patients,promoting the efficacy of gastroscopy and relieving clinical symptoms of patients in the treatment of chronic atrophic gastritis,and it does not increase the incidence of adverse reactions in patients.However,more high-quality and large sample

关 键 词：慢性萎缩性胃炎 清热祛湿 随机对照试验 

分 类 号：R256.3[医药卫生—中医内科学]