柴芍六君子汤加减治疗肝郁脾虚型慢性萎缩性胃炎疗效与安全性的Meta分析  

A Meta-analysis of the efficacy and safety of the Chaishao Liujunzi decoction on chronic atrophic gastritis with liver depression and spleen deficiency type

作　　者：蒲慧云 陈宏慈 彭双立 PU Huiyun

机构地区：[1]湖北中医药大学,湖北武汉430061 [2]湖北中医药大学附属湖北省中医院,湖北武汉430061

出　　处：《中医临床研究》2024年第5期95-101,共7页Clinical Journal Of Chinese Medicine

摘　　要：目的:系统评价和分析柴芍六君子汤加减治疗肝郁脾虚型慢性萎缩性胃炎的临床疗效和安全性。方法:通过计算机检索各个数据库(中国生物医学文献服务系统、中国知网数据库、重庆维普中文科技期刊数据库、万方数据库、PubMed),获取关于柴芍六君子汤加减治疗慢性萎缩性胃炎患者的相关文献,时间限定从建库至2021年,由2名人员独立进行文献的检索与筛查,如遇分歧由第3方解决,最后选择符合要求的文献。利用Cochrane协作网研发的RevMan5.4软件进行Meta分析。结果:共纳入16篇随机对照试验,样本量计1454例,结果显示柴芍六君子汤治疗肝郁脾虚型慢性萎缩性胃炎具有较好临床疗效、安全性高,可有效降低中医症状积分、有效提高生活质量评分、在提高幽门螺杆菌根除率、改善血清学指标[胃泌素-17(Gastrin-17,G-17)、胃蛋白酶原(Pepsinogen,PG)Ⅰ、PGII]等方面具有一定优势,在改善胃黏膜萎缩和肠化方面也具有一定优势,但改善异型增生无明显优势。结论:采用柴芍六君子汤加减或者是柴芍六君子汤加减联合对照组用药治疗肝郁脾虚型慢性萎缩性胃炎的疗效优于单纯西医治疗,但由于纳入的文献质量不高,偏倚风险较高、样本量少,故建议进一步开展具有合理设计、样本量充足以及结局指标完善的临床试验进行研究与评价。Objective:To systematically evaluate and analyze the clinical efficacy and safety of the Chaishao Liujunzi decoction(柴芍六君子汤)on chronic atrophic gastritis with liver depression and spleen deficiency type.Methods:Using computer to search all kinds of databases(CBM,CNKI database,VIP database,Wanfang database and PubMed),the relevant literatures on the treatment of chronic phic gastritis patients with the Chaishao Liujunzi decoction were obtained from the establishment of the databaseO to 2021.Literature retrieval and screening shall be carried out independently by two persons.In case of disagreement,the third party shall solve the disagreement and finally select the literature that meets the requirements.The Meta-analysis was performed using RevMan 5.4 software from the Cochrane collaboration.Results:A total of 16 randomized controlled trials were included,with a sample size of 1454 people.The Meta-analysis showed that the Chaishao Liujunzi decoction had significant advantages in improving TCM symptom scores and quality of life scores of patients with chronic atrophic gastritis syndrome of liver depression and spleen deficiency type.It has certain advantages in helicobacter pylori eradication rate,improvement of serological indicators(G-17,PGI,PGII),and improvement of gastric mucosal atrophy and intestinal metaplasia,but there is no obvious advantage in the improvement of dysplasia.Conclusion:The therapeutic effect of the Chaishao Liujunzi decoction or Chaishao Liujunzi decoction combined with western medicine or proprietary chinese medicineson chronic atrophic gastritis of liver stagnation and spleen deficiency is better than western medicine alone.Due to the low quality of the included literature,high risk of bias and small sample size,it is suggested to further carry out the study and evaluation of clinical trials with reasonable design,sufficient sample size and complete outcome indicators.

关 键 词：柴芍六君子汤 肝郁脾虚 慢性萎缩性胃炎 META分析 

分 类 号：R573.3[医药卫生—消化系统]