中药联合抗抑郁药治疗与单纯西药治疗功能性消化不良系统评价
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摘要
目的:评价中药联合抗抑郁药治疗功能性消化不良的随机对照试验疗效。方法:通过检索网上电子数据库及手工检索相关会议文献,筛选合格研究,提取有效率、不良反应等信息,使用Revman5.3软件进行META分析。有潜在异质性风险时进行亚组分析,并分别进行发表偏倚分析、敏感性分析。结果:有效率:共纳入文献13篇,经异质性检验,P=0.81,I~2=0,统计学认为各项研究同质,OR:4.25,95%CI(3.16,5.71),P<0.01,中药联合抗抑郁药治疗功能性消化不良相对常规西药治疗疗效有优势。不良反应方面提及文献较少,异质性较高,应进行更明确的临床试验。结论:中药联合抗抑郁药治疗功能性消化不良的疗效优于传统西药治疗,但不良反应仍需可靠的临床试验证明。
Objective:To evaluate the efficacy of traditional Chinese medicine combined with antidepressants in treatment of functional dyspepsia randomized controlled trials. Methods:Relevant literatures were reviewed via database and assessed via randomized controlled trial(RCT)scale. Screening of qualified research,extraction efficiency,adverse reactions and other information,data statistical analysis was performed by Rev Man 5.3 software. Results:Clinical efficient:since test for heterogeneity:P=0.81,I~2=0,it indicated the data had homogeneity,OR:4.25,95%CI(3.16,5.71),P<0.01,It meant that integration of traditional Chinese and antidepressant treatment for functional dyspepsia in improving clinical symptom had obvious advantages compared with Western medicine. There were few literatures about adverse reaction mentioned,and those literatures have heterogeneity,more large-scale RCTs with high quality are required to attest it. Conclusion:Integration treatment for functional dyspepsia shows good curative effect,and there are obvious advantages compared with Western medicine,but more large-scale RCTs with high quality are required to attest integration treatment has few adverse reactions.
Objective:To evaluate the efficacy of traditional Chinese medicine combined with antidepressants in treatment of functional dyspepsia randomized controlled trials. Methods:Relevant literatures were reviewed via database and assessed via randomized controlled trial(RCT)scale. Screening of qualified research,extraction efficiency,adverse reactions and other information,data statistical analysis was performed by Rev Man 5.3 software. Results:Clinical efficient:since test for heterogeneity:P=0.81,I~2=0,it indicated the data had homogeneity,OR:4.25,95%CI(3.16,5.71),P<0.01,It meant that integration of traditional Chinese and antidepressant treatment for functional dyspepsia in improving clinical symptom had obvious advantages compared with Western medicine. There were few literatures about adverse reaction mentioned,and those literatures have heterogeneity,more large-scale RCTs with high quality are required to attest it. Conclusion:Integration treatment for functional dyspepsia shows good curative effect,and there are obvious advantages compared with Western medicine,but more large-scale RCTs with high quality are required to attest integration treatment has few adverse reactions.
引文
[1]王长洪.著名中医学家董建华教授学术经验系列之一功能性消化不良的论治经验[J].名医精诚,1997,26(7):289.
[2]仝甲钊,曲波,王蓓蓓,等.功能性消化不良的发病机制[J].世界华人消化杂志,2013,21(9):785-790.
[3]Wu JC.Community-based study on psychological comorbidity in functional gastrointestinal disorder[J].J Gastroenterol Hepatol,2011,26(3):23-26.
[4]Nan JF,Liu JX,Mu JY,et al.Brain-based correlations between psychological factors and functional dyspepsia[J].Journal Neurogastroenterology and Motility,2015,21(1):103-110.
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[8]佘妙华.疏肝健脾方治疗功能性消化不良的临床观察[D].石家庄:河北医科大学,2013.
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[10]刘高峰,呼延智伟,杜华春,等.加味越鞠丸联合黛力新治疗功能性消化不良32例[J].中国药物经济学,2013(3):259-260.
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[13]张晋平,赵瑞华.中西医结合治疗功能性消化不良疗效观察[J].世界中西医结合杂志,2007,2(12):726-727.
[14]张雅云,王晓琳,杨红杰,等.胃安胶囊联合氟哌噻吨美利曲辛片治疗功能性消化不良45例[J].中医研究,2014,27(12):11-12.
[15]徐奔,谭远忠.加味枳术丸联合黛力新治疗功能性消化不良疗效观察[J].湖北中医杂志,2010,32(9):43-44.
[16]王琦苑,李天望.柴胡疏肝散联合黛力新治疗更年期综合征功能性消化不良[J].湖北中医杂志,2009,31(6):34-35.
[17]甘辉虎.健脾疏肝方联合黛力新治疗老年妇女功能性消化不良88例[J].中国中医药现代远程教育,2014,12(16):46-47.
[18]管录宇.柴胡疏肝散联合黛力新治疗功能性消化不良55例[J].国医论坛,2013,28(6):41.
[19]陈一平,臧家琪.疏肝调胃汤加黛力新治疗功能性消化不良观察[J].中医药学刊,2006,24(10):1966-1967.
[20]Jackson JL,O'Malley PG,Tomkins G,et al.Treatment of functional gastrointestinal disorders with antidepressant medications:ameta-analysis[J].Am J Med,2000,108(1):65-72.
[21]李伟冬,贾林,江舒曼,等.联合运用抗抑郁药治疗功能性消化不良疗效及安全性的Meta分析[J].中华临床医师杂志,2013,7(3):1151-1156.
[22]中华中医药学会内科脾胃专业委员会.功能性消化不良中医诊治规范[J].中国中西医结合杂志,2002,10(4):158.
[23]刘佳丽,张毅杰,宋永喜,等.中西药治疗功能性消化不良随机对照试验的系统评价[J].中国循证医学杂志,2009,9(12):1315-1322.
[24]Wang C,Zhu M,Xia W,et al.Meta-analysis of traditional Chinese medicine in treating functional dyspepsia of liverstomach disharmony syndrome[J].Tradit Chin Med,2012,32(4):515-22.
[25]Xiao Y,Liu YY,Yu KQ,et al.Chinese herbal medicine liu jun zi tang and xiang sha liu jun zi tang for functional dyspepsia:meta-analysis of randomized controlled trials[J].Evid Based Complement Alternat Med,2012(1):277-293.
[2]仝甲钊,曲波,王蓓蓓,等.功能性消化不良的发病机制[J].世界华人消化杂志,2013,21(9):785-790.
[3]Wu JC.Community-based study on psychological comorbidity in functional gastrointestinal disorder[J].J Gastroenterol Hepatol,2011,26(3):23-26.
[4]Nan JF,Liu JX,Mu JY,et al.Brain-based correlations between psychological factors and functional dyspepsia[J].Journal Neurogastroenterology and Motility,2015,21(1):103-110.
[5]Barry S,Dinan TG.Functionaldyspepsia:are psychosocial factors of relevance[J].World JGastroentero,2006,12(17):2701-2707.
[6]Rosenthal R.The file-drawer problem and tolerance of nul result[J].Psychol Bull,1979,86(45):638-641.
[7]石修权,曹博玲.用失安全系数判断发表偏倚的效果及对策[J].中国医学创新,2012,26(9):134-136.
[8]佘妙华.疏肝健脾方治疗功能性消化不良的临床观察[D].石家庄:河北医科大学,2013.
[9]刘芊.大柴胡汤加减方联合黛力新治疗顽固性功能性消化不良60例疗效观察[J].北京中医药,2010,29(10):779-780.
[10]刘高峰,呼延智伟,杜华春,等.加味越鞠丸联合黛力新治疗功能性消化不良32例[J].中国药物经济学,2013(3):259-260.
[11]周梦煜.益胃汤合氟西汀治疗功能性消化不良50例[J].河南中医,2006,26(6):66-67.
[12]张富山,李松岩.解郁和胃汤联合小剂量多塞平治疗功能性消化不良60例[J].中医研究,2009,22(5):35-36.
[13]张晋平,赵瑞华.中西医结合治疗功能性消化不良疗效观察[J].世界中西医结合杂志,2007,2(12):726-727.
[14]张雅云,王晓琳,杨红杰,等.胃安胶囊联合氟哌噻吨美利曲辛片治疗功能性消化不良45例[J].中医研究,2014,27(12):11-12.
[15]徐奔,谭远忠.加味枳术丸联合黛力新治疗功能性消化不良疗效观察[J].湖北中医杂志,2010,32(9):43-44.
[16]王琦苑,李天望.柴胡疏肝散联合黛力新治疗更年期综合征功能性消化不良[J].湖北中医杂志,2009,31(6):34-35.
[17]甘辉虎.健脾疏肝方联合黛力新治疗老年妇女功能性消化不良88例[J].中国中医药现代远程教育,2014,12(16):46-47.
[18]管录宇.柴胡疏肝散联合黛力新治疗功能性消化不良55例[J].国医论坛,2013,28(6):41.
[19]陈一平,臧家琪.疏肝调胃汤加黛力新治疗功能性消化不良观察[J].中医药学刊,2006,24(10):1966-1967.
[20]Jackson JL,O'Malley PG,Tomkins G,et al.Treatment of functional gastrointestinal disorders with antidepressant medications:ameta-analysis[J].Am J Med,2000,108(1):65-72.
[21]李伟冬,贾林,江舒曼,等.联合运用抗抑郁药治疗功能性消化不良疗效及安全性的Meta分析[J].中华临床医师杂志,2013,7(3):1151-1156.
[22]中华中医药学会内科脾胃专业委员会.功能性消化不良中医诊治规范[J].中国中西医结合杂志,2002,10(4):158.
[23]刘佳丽,张毅杰,宋永喜,等.中西药治疗功能性消化不良随机对照试验的系统评价[J].中国循证医学杂志,2009,9(12):1315-1322.
[24]Wang C,Zhu M,Xia W,et al.Meta-analysis of traditional Chinese medicine in treating functional dyspepsia of liverstomach disharmony syndrome[J].Tradit Chin Med,2012,32(4):515-22.
[25]Xiao Y,Liu YY,Yu KQ,et al.Chinese herbal medicine liu jun zi tang and xiang sha liu jun zi tang for functional dyspepsia:meta-analysis of randomized controlled trials[J].Evid Based Complement Alternat Med,2012(1):277-293.