多种方案治疗寒热错杂型功能性消化不良的网状meta分析  

A network meta-analysis of multiple treatments for functional dyspepsia of the cold-heat complex type

作　　者：黄崇政 沈浮 文绍鹤 唐成 彭芮 HUANG Chongzheng;SHEN Fu;WEN Shaohe;TANG Cheng;PENG Rui(Department of Internal Medicine,the Affiliated Yongzhou Traditional Chinese Medicine Hospital of Hunan University of Chinese Medicine,Hunan Province,Yongzhou 425000,China)

机构地区：[1]湖南医药学院附属永州市中医医院内科,湖南永州425000

出　　处：《中国当代医药》2025年第8期12-18,共7页China Modern Medicine

基　　金：国家中医药管理局全国名老中医药专家传承工作室建设项目(国中医药人教函〔2022〕75号);湖南中医药管理局课题(B2024154)。

摘　　要：目的本研究旨在通过网状meta分析探讨不同治疗方法对寒热错杂型功能性消化不良(FD)的疗效差异。方法检索中国知网、万方数据库、维普网、PubMed、Embase和Web of Science等数据库,收集关于治疗寒热错杂型FD的随机对照试验(RCT)。利用ADDIS软件和R 3.6.1软件中的gemtc包对所收集文献中的临床总有效率数据进行网状meta分析,以评估不同治疗方案的效果。结果共纳入20个RCT,涉及1818例患者,其中试验组患者910例,对照组患者918例,共涉及7种用药方案:西药口服、中药口服、中药口服+西药口服、中药口服+针灸疗法、穴位埋线、中药口服+穴位贴敷、中药口服+音乐疗法。网状meta分析结果显示:在总有效率排序方面,中药口服+音乐疗法>中药口服+针灸疗法>中药口服+西药口服>穴位埋线>中药口服+穴位贴敷>中药口服>西药口服。在提高血清胃泌素水平方面,由优到劣依次为中药口服+针灸疗法>中药口服>中药口服+穴位贴敷>穴位埋线>西药口服。受纳入研究质量限制,此结论需更多高质量研究进行验证。结论中药口服联合音乐疗法在治疗寒热错杂型FD的有效率方面效果最优,而中药口服联合针灸疗法更加有利于提高血清胃泌素水平,但结论仍需更多高质量的RCT进一步验证,临床中可根据患者的具体临床特征选取最优的疗法。Objective To explore the efficacy differences of various treatment methods for cold-heat complex type Functional Dyspepsia(FD)through a network meta-analysis.Methods Randomised controlled trials(RCTS)on the treatment of cold-heart complex type FD were collected by searching CNKI,Wanfang Database,Wepnet,PubMed,Embase and Web of Science.Mesh meta-analysis of clinical total response rate data from the collected literature was performed using ADDIS software and the gemtc package in R 3.6.1 software to assess the effects of different treatment options.Results A total of 20 RCTs involving 1818 patients were included,with 910 patients in the experimental group and 918 in the control group,covering 7 medication plans:oral Western medicine,oral Chinese medicine,oral Chinese medicine+oral Western medicine,oral Chinese medicine+acupuncture therapy,acupoint embedding,oral Chinese medicine+acupoint plaster,and oral Chinese medicine+music therapy.The network meta-analysis results showed that in terms of total effective rate ranking,oral Chinese medicine+music therapy>oral Chinese medicine+acupuncture therapy>oral Chinese medicine+oral Western medicine>acupoint embedding>oral Chinese medicine+acupoint plaster>oral Chinese medicine>oral Western medicine.In terms of increasing serum gastrin levels,the order from best to worst was oral Chinese medicine+acupuncture therapy>oral Chinese medicine>oral Chinese medicine+acupoint plaster>acupoint embedding>oral Western medicine.Due to the quality limitations of the included studies,this conclusion requires further verification by more high-quality studies.Conclusion The combination of oral Chinese medicine and music therapy has the best efficacy in treating cold-heat complex type FD,while the combination of oral Chinese medicine and acupuncture therapy is more conducive to increasing serum gastrin levels.However,these conclusions still require further verification by more high-quality RCTs.In clinical practice,the optimal therapy can be chosen based on the specific clinical characterist

关 键 词：寒热错杂型 功能性消化不良 网状meta分析 中医药 中西医结合 西医 随机对照试验 

分 类 号：R259[医药卫生—中西医结合]