中药保留灌肠治疗溃疡性结肠炎疗效的荟萃分析
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摘要
目的:系统评价中药保留灌肠治疗溃疡性结肠炎(ulcerative colitis,UC)的有效性和安全性。方法:检索CochraneLibrary、PubMed、中国期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、万方数据库(Wanfang Data)、中文科技期刊全文数据库(VIP)建库至2017年7月的所有文献。按照Cochrane系统评价方法查找中药保留灌肠治疗UC的临床随机对照试验(RCTs),进行数据提取和质量评价后,采用RevMan 5.3软件进行荟萃(meta)分析。结果:共纳入36篇文献。Meta分析结果显示:治疗组的总有效率优于对照组[RR=1.20,95%CI(1.15,1.25),P<0.000 01];治疗后治疗组中医证候积分低于对照组[SMD=-1.55,95%CI(-2.03,-1.07),P<0.000 01];治疗后治疗组内镜积分低于对照组[SMD=-1.63,95%CI(-2.45,-0.81),P<0.000 1];治疗组复发率低于对照组[RR=0.36,95%CI(0.25,0.52),P<0.000 01];治疗组药品不良反应(ADRs)发生率低于对照组[RR=0.23,95%CI(0.12,0.44),P<0.000 1]。结论:中药保留灌肠治疗可以提高UC的总有效率,减轻相关症状,同时有效降低UC的复发率,减少ADRs发生率。
Objective:To systematically evaluate the efficacy and safety of retention enema with Chinese materia medica in the treatment of ulcerative colitis(UC).Methods:The databases,such as Cochrane Library,PubMed,the Chinese Journal Fulltext Database in China National Knowledge Infrastructure(CNKI),the Chinese Biomedical Literature Database(CBM),Wanfang data and the China Science and Technology Journal Database(VIP)were searched from the inception to July,2017 to collect randomized controlled trials(RCT)in the treatment of UC by retention enema with Chinese materia medica,according to Cochrane Collaboration system review.After data collection and quality evaluation,meta analysis was performed using RevMan5.3 software.Results:A total of 36 RCTs were included.Results of meta analysis showed that total efficacy of the treatment group was higher than that of the control group[RR=1.20,95%CI(1.15,1.25),P<0.000 01].After treatment,the traditional Chinese medical syndrome scores of the treatment group were lower than those of the control group[SMD=-1.55,95%CI(-2.03,-1.07),P<0.000 01].The endoscopic scores of the treatment group were lower than those of the control group[SMD=-1.63,95%CI(-2.45,-0.81),P<0.000 1].The recurrent rate of the treatment group was lower than that of the control group[RR=0.36,95%CI(0.25,0.52),P<0.000 01].The rate of adverse drug reactions(ADRs)of the treatment group was also lower than that of the control group[RR=0.23,95%CI(0.12,0.44),P<0.000 1].Conclusion:Current limited evidence suggests that retention enema with Chinese materia medica in the treatment of UC could improve total efficacy of the treatment,alleviate the related symptoms and reduce the recurrent rate and the rate of ADRs in UC.
Objective:To systematically evaluate the efficacy and safety of retention enema with Chinese materia medica in the treatment of ulcerative colitis(UC).Methods:The databases,such as Cochrane Library,PubMed,the Chinese Journal Fulltext Database in China National Knowledge Infrastructure(CNKI),the Chinese Biomedical Literature Database(CBM),Wanfang data and the China Science and Technology Journal Database(VIP)were searched from the inception to July,2017 to collect randomized controlled trials(RCT)in the treatment of UC by retention enema with Chinese materia medica,according to Cochrane Collaboration system review.After data collection and quality evaluation,meta analysis was performed using RevMan5.3 software.Results:A total of 36 RCTs were included.Results of meta analysis showed that total efficacy of the treatment group was higher than that of the control group[RR=1.20,95%CI(1.15,1.25),P<0.000 01].After treatment,the traditional Chinese medical syndrome scores of the treatment group were lower than those of the control group[SMD=-1.55,95%CI(-2.03,-1.07),P<0.000 01].The endoscopic scores of the treatment group were lower than those of the control group[SMD=-1.63,95%CI(-2.45,-0.81),P<0.000 1].The recurrent rate of the treatment group was lower than that of the control group[RR=0.36,95%CI(0.25,0.52),P<0.000 01].The rate of adverse drug reactions(ADRs)of the treatment group was also lower than that of the control group[RR=0.23,95%CI(0.12,0.44),P<0.000 1].Conclusion:Current limited evidence suggests that retention enema with Chinese materia medica in the treatment of UC could improve total efficacy of the treatment,alleviate the related symptoms and reduce the recurrent rate and the rate of ADRs in UC.
引文
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[6]贾慧玲,白国民.三七阿胶汤保留灌肠治疗慢性非特异性溃疡性结肠炎50例临床观察[J].河北中医,2009,31(5):666-667.JIA Huiling,BAI Guomin.Clinical observation on retention enema with Sanqiejiao decoction in the treatment of chronic nonspecific ulcerative colitis:50cases[J].Hebei J Tradit Chin Med,2009,31(5):666-667.In Chinese.
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