健脾祛瘀法治疗慢性萎缩性胃炎伴肠上皮化生的Meta分析
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摘要
目的通过对纳入的以健脾祛瘀法立方治疗慢性萎缩性胃炎伴肠上皮化生的临床随机对照文献Meta分析,为健脾祛瘀法治疗慢性萎缩性胃炎伴肠上皮化生方案的设计提供循证支持。方法对发表在万方数据库、中国期刊全文数据库、维普中文科技期刊数据库、PubMed等全文数据库收录的有关健脾祛瘀法治疗慢性萎缩性胃炎伴肠上皮化生的临床随机对照试验进行检索,应用Jadad量表对纳入文献进行质量学评价,并通过统计学软件Review Manager 5.3对纳入文献分析。结果共纳入文献10篇,Jadad量表评分示7项研究在4分及4分以上。与对照组比较,临床疗效Meta分析结果示OR=5.53,95%CI=[3.83,7.99],Z=9.13(<0.00001);胃镜改善情况Meta分析结果示OR=3.06,95%CI=[2.11,4.43],Z=5.89(<0.00001);病理改善情况Meta分析结果示OR=3.07,95%CI=[2.24,4.22],Z=6.94(<0.00001),纳入文献4项研究进行了安全性评价,1项研究发现试验方治疗后出现便溏,其他均无明显不良反应,6项研究安全性评价不明。结论健脾祛瘀法治疗慢性萎缩性胃炎伴肠上皮化生安全有效,临床值得推广。
Objective To provide evidence-based support for the design of the scheme of invigorating the spleen and removing blood stasis in treatment of chronic atrophic gastritis with intestinal metaplasia. Methods Randomized controlled trials on the treatment of chronic atrophic gastritis with intestinal metaplasia by invigorating spleen and removing blood stasis were retrieved from Wanfang database,Chinese Journal Full-text database, VIP Chinese scientific journal database,PubMed and other full-text databases. The quality of the included literatures was evaluated by Jadad scale. And statistical software Review Manager 5.3 was included in the literature analysis. Results A total of 10 articles were included in the study, and the Jadad scale showed 7 studies in 4 and 4. Compared with control group, the Meta-analysis of clinical efficacy showed OR=5.53,95%CI=[3.83,7.99],Z=9.13(P<0.00001); the Meta-analysis of gastroscopic improvement showed OR=3.06,95% CI=[2.11,4.43],Z=5.89(P<0.00001); the Meta-analysis of pathological improvement showed OR=3.07,95% CI=[2.24,4.22], Z= 6.94(P<0.00001),which was included in the literature. The safety of the study was evaluated. One study found that feces developed after treatment,and no other adverse reactions were observed. The safety evaluation of 6 studies was unclear. Conclusion The method of invigorating spleen and removing blood stasis is safe and effective in treatment of chronic atrophic gastritis with intestinal metaplasia.
Objective To provide evidence-based support for the design of the scheme of invigorating the spleen and removing blood stasis in treatment of chronic atrophic gastritis with intestinal metaplasia. Methods Randomized controlled trials on the treatment of chronic atrophic gastritis with intestinal metaplasia by invigorating spleen and removing blood stasis were retrieved from Wanfang database,Chinese Journal Full-text database, VIP Chinese scientific journal database,PubMed and other full-text databases. The quality of the included literatures was evaluated by Jadad scale. And statistical software Review Manager 5.3 was included in the literature analysis. Results A total of 10 articles were included in the study, and the Jadad scale showed 7 studies in 4 and 4. Compared with control group, the Meta-analysis of clinical efficacy showed OR=5.53,95%CI=[3.83,7.99],Z=9.13(P<0.00001); the Meta-analysis of gastroscopic improvement showed OR=3.06,95% CI=[2.11,4.43],Z=5.89(P<0.00001); the Meta-analysis of pathological improvement showed OR=3.07,95% CI=[2.24,4.22], Z= 6.94(P<0.00001),which was included in the literature. The safety of the study was evaluated. One study found that feces developed after treatment,and no other adverse reactions were observed. The safety evaluation of 6 studies was unclear. Conclusion The method of invigorating spleen and removing blood stasis is safe and effective in treatment of chronic atrophic gastritis with intestinal metaplasia.
引文
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[10]郑逢民,郑乐乐,郑中坚.消痞愈萎汤联合胃复春片治疗慢性萎缩性胃炎伴胃黏膜肠上皮化生或异型增生64例临床观察[J].中医杂志,2015,56(4):311-314.
[11]顾志坚,唐人彦,林江,等.莪连颗粒治疗脾虚瘀热型慢性萎缩性胃炎伴肠化生临床随机对照研究[J].上海中医药杂志,2015,49(4):40-43.
[12]刘晏,刘元霞,李琼,等.安中复元方治疗慢性萎缩性胃炎合并肠化的临床观察[J].中成药,2015,37(12):2605-2610.
[13]栾洋,顾娜,王伟,等.晚期胃低分化腺癌多学科治疗1例[J].临床肿瘤学杂志,2015,20(10):957-958.
[14]彭庆娟,蔡克银.中西医治疗慢性萎缩性胃炎研究进展[J].浙江中医药大学学报,2013,37(3):359-362.
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[17]潘华峰,赵自明,任金玲,等.胃痞消对慢性萎缩性胃炎大鼠胃黏膜上皮细胞肠上皮化生的影响[J].中药新药与临床药理,2012,23(1):55-57.
[2]梁万年.医学科研方法学[M].北京:人民卫生出版社,2002:451-486.
[3]白海燕,郭立芳,杜艳茹,等.活血解毒方治疗慢性萎缩性胃炎并轻、中度肠上皮化生的临床观察[J].上海中医药杂志,2007,41(6):37-38.
[4]王宁,张国.活胃治萎汤治疗慢性萎缩性胃炎伴肠上皮化生疗效观察[J].陕西中医,2011,32(8):1010-1011.
[5]李志钢,薛红,张伟,等.王氏胃萎宁治疗萎缩性胃炎伴肠化生的临床研究[J].四川中医,2010,28(3):53-56.
[6]黄柳向.莪蚕健胃汤治疗慢性萎缩性胃炎伴肠化生的临床研究[J].中国中西医结合消化杂志,2011,19(6):397-399.
[7]冯丹青,朱梅萍,施慧婷.肠化方加减治疗慢性萎缩性胃炎伴肠上皮化生临床疗效观察[J].上海中医药大学学报,2013,27(2):32-35.
[8]杨少军,汪龙德,张晶,等.平胃胶囊治疗慢性萎缩性胃炎癌前病变45例临床研究[J].中医杂志,2014,55(20):1745-1749.
[9]林启有,陈瑞发,欧阳东亮.柴芍消痞汤治疗慢性萎缩性胃炎伴肠上皮化生的临床研究[J].中西医结合研究,2014,6(4):204-205.
[10]郑逢民,郑乐乐,郑中坚.消痞愈萎汤联合胃复春片治疗慢性萎缩性胃炎伴胃黏膜肠上皮化生或异型增生64例临床观察[J].中医杂志,2015,56(4):311-314.
[11]顾志坚,唐人彦,林江,等.莪连颗粒治疗脾虚瘀热型慢性萎缩性胃炎伴肠化生临床随机对照研究[J].上海中医药杂志,2015,49(4):40-43.
[12]刘晏,刘元霞,李琼,等.安中复元方治疗慢性萎缩性胃炎合并肠化的临床观察[J].中成药,2015,37(12):2605-2610.
[13]栾洋,顾娜,王伟,等.晚期胃低分化腺癌多学科治疗1例[J].临床肿瘤学杂志,2015,20(10):957-958.
[14]彭庆娟,蔡克银.中西医治疗慢性萎缩性胃炎研究进展[J].浙江中医药大学学报,2013,37(3):359-362.
[15]陈艳哲.慢性萎缩性胃炎伴肠上皮化生的中医证候特点探讨[D].石家庄:河北医科大学,2011.
[16]邱岳.化瘀解毒益气法治疗慢性萎缩性胃炎伴肠上皮化生的临床研究[D].北京:北京中医药大学,2010.
[17]潘华峰,赵自明,任金玲,等.胃痞消对慢性萎缩性胃炎大鼠胃黏膜上皮细胞肠上皮化生的影响[J].中药新药与临床药理,2012,23(1):55-57.