康复新液联用益生菌治疗溃疡性结肠炎Meta分析
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摘要
目的:评价康复新液联用益生菌治疗溃疡性结肠炎(UC)的有效性及安全性。方法:计算机检索Cochrane Library、Pub Med、Embase、中国生物医学文献数据库(CBM),中国科技期刊全文数据库(VIP),中国期刊全文数据库(CNKI)和万方数据库,收集关于康复新液联用益生菌治疗溃疡性结肠炎的随机对照试验。由两名研究者独立进行资料提取和文献质量评价,采用Rev Man 5. 3软件进行Meta分析。结果:最终纳入11个RCT,1022例患者。Meta分析结果显示,与对照组相比,试验组能够明显提高溃疡性结肠炎治疗的临床有效率[OR=5. 59,95%CI (3. 52,8. 88),P <0. 00001],改善结肠镜下黏膜病变疗效,但不能降低不良反应发生率[OR=1. 27,95%CI(0. 60,2. 69),P=0. 53]。漏斗图分析显示不对称,可能存在发表偏倚。结论:康复新液联用益生菌对溃疡性结肠炎有更好的疗效,但由于纳入文献质量较低,且文献数量偏少,需要进一步开展更多高质量、大样本的随机双盲试验。
Objective: To systematically evaluate the clinical efficacy and safety of Kangfuxin Liquid combined with probiotics in treating ulcerative colitis. Methods: Databases such as Cochrane Library,Pub Med,Embase,CBM,VIP,CNKI and Wanfang were searched for randomized controlled trials about Kangfuxin Liquid combined with probiotics as the interventions for ulcerative colitis. Two researchers independently screened the literature,extracted the data and evaluated the methodological quality according to the inclusion and exclusion criteria. Rev Man 5. 3 was used to revaluate the results of the total effect of Meta-analysis. Results: Eleven RCTs involving 1022 patients were included into the study. The Meta-analysis results showed that compared with the control group,Kangfuxin Liquid combined with probiotics can significantly improve the clinical effective rate[OR = 5. 59,95% CI(3.52,8. 88),P < 0. 00001],improve the endoscopic mucosal lesions,but can not significantly reduce adverse reactions incidence[OR = 1. 27,95% CI(0. 60,2. 69),P = 0. 53]. Funnel plot analysis showed potential bias. Conclusion: Kangfuxin Liquid combined with probiotics in treatment of ulcerative colitis has good therapeutic effect. However,due to the low methodology and less study,more high-quality,double-blind trials with a large sample size are required to further evaluate the efficacy and safety of Kangfuxin Liquid combined with probiotics in treating ulcerative colitis.
Objective: To systematically evaluate the clinical efficacy and safety of Kangfuxin Liquid combined with probiotics in treating ulcerative colitis. Methods: Databases such as Cochrane Library,Pub Med,Embase,CBM,VIP,CNKI and Wanfang were searched for randomized controlled trials about Kangfuxin Liquid combined with probiotics as the interventions for ulcerative colitis. Two researchers independently screened the literature,extracted the data and evaluated the methodological quality according to the inclusion and exclusion criteria. Rev Man 5. 3 was used to revaluate the results of the total effect of Meta-analysis. Results: Eleven RCTs involving 1022 patients were included into the study. The Meta-analysis results showed that compared with the control group,Kangfuxin Liquid combined with probiotics can significantly improve the clinical effective rate[OR = 5. 59,95% CI(3.52,8. 88),P < 0. 00001],improve the endoscopic mucosal lesions,but can not significantly reduce adverse reactions incidence[OR = 1. 27,95% CI(0. 60,2. 69),P = 0. 53]. Funnel plot analysis showed potential bias. Conclusion: Kangfuxin Liquid combined with probiotics in treatment of ulcerative colitis has good therapeutic effect. However,due to the low methodology and less study,more high-quality,double-blind trials with a large sample size are required to further evaluate the efficacy and safety of Kangfuxin Liquid combined with probiotics in treating ulcerative colitis.
引文
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[13]谭斌.益生菌加康复新液治疗活动期轻中度溃疡性结肠炎的效果及安全性观察[J].中国社区医师,2017,33(2):96-98.
[14]谢天维.康复新液联合益生菌应用于活动期轻中度溃疡性结肠炎的安全性及效果观察[J].医学信息,2016,29(26):149-150.
[15]常青霞.康复新液联合美沙拉嗪治疗溃疡性结肠炎疗效观察[J].中国实用医药,2016,11(33):136-137.
[16]董青.康复新液灌肠联合美沙拉嗪治疗溃疡性结肠炎疗效观察[J].中国中西医结合消化杂志,2011,19(4):252-253.
[17]周文博,曾宏翔,林震群.康复新液联合美常安及柳氮磺吡啶治疗溃疡性结肠炎疗效观察[J].医药前沿,2013(30):239.
[18]赵丽丽.康复新液灌肠联合美沙拉嗪治疗溃疡性结肠炎的疗效评价[J].世界最新医学信息文摘,2015,15(57):116-117.
[19]Jiang LY,Liu X,Xia CL,et al.Research advance on chemical constituents and anti-tumor effects of periplaneta americana L[J].Medicinal Plant,2012,5:95-97.
[20]郑重,陈维雄,陈尼维,等.康复新液对急性大鼠实验性结肠炎作用机制的研究[J].胃肠病学,2008,13(1):31-34.
[21]张春林.康复新液治疗溃疡性结肠炎鼠模型的疗效观察及机制初探[D].北京:中国协和医科大学北京协和医院,2015.
[22]苗政,钱家鸣,李景南,等.康复新液对小鼠噁唑酮结肠炎的疗效及其机制初探[J].胃肠病学,2012,17(8):457-461.
[23]陆允敏,金湧,陈维雄,等.康复新液治疗小鼠实验性结肠炎的研究[J].中国临床医学,2011,18(4):446-449.
[24]王朋川,何苗,张汉超,等.康复新液对2,4-二硝基氯苯联合醋酸诱导大鼠溃疡性结肠炎的影响[J].大理大学学报,2016,1(4):17-21.
[25]赵纯成,周钢,李远洪,等.益生菌制剂对溃疡型结肠炎患者血清炎性介质的影响[J].西南国防医药,2015,25(1):27-29.
[26]谢晶日,孙涛,张杨,等.益生菌在肠病中的应用及安全性[J].胃肠病学和肝病学杂志,2014,23(10):1113-1115.
[2]Saleh M,Trinchieri G.Innate immune mechanisms of colitis and colitis-associated colorectal cancer[J].Nat Rev Immunol,2011,11(1):9-20.
[3]杨雯,王陆陆,向虹宇,等.康复新液对小鼠的免疫调节作用[J].华西药学杂志,2011,26(6):543-546.
[4]范照三,赵海军.康复新液对口腔溃疡兔的血清中SOD和MDA的影响[J].华西药学杂志,2015,30(3):390.
[5]中华医学会消化病学分会炎症性肠病学组.炎症性肠病诊断与治疗的共识意见[J].中华内科杂志,2012,51(10):818-831.
[6]中华医学会消化病学分会.对炎症性肠病诊断治疗规范的建议[J].中华消化杂志,2001,21(4):236-239.
[7]Higgins J,Green S.Cochrane Collaboration:Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0[S].John Wiley Sons Ltd and The Cochrane Collaboration,Chichester,2011.
[8]白杨.康复新液结合酪酸梭菌肠球菌三联活菌片用于活动期轻中度溃疡性结肠炎治疗临床分析[J].人人健康,2016(22):18.
[9]李远洪.双歧杆菌联合康复新液治疗重度溃疡性结肠炎的疗效观察[J].中国当代医药,2016,23(20):138-140.
[10]阮青华,洪英.益生菌联合康复新液治疗溃疡性结肠炎临床分析[J].国外医药抗生素分册,2015,36(4):187-188.
[11]刘昆.益生菌联合康复新液对于活动期轻中度溃疡性结肠炎的治疗效果分析[J].中国继续医学教育,2015,7(18):212-213.
[12]谌丽华.益生菌联合康复新液治疗活动期轻中度溃疡性结肠炎的临床效果探讨[J].基层医学论坛,2016,20(25):3500-3501.
[13]谭斌.益生菌加康复新液治疗活动期轻中度溃疡性结肠炎的效果及安全性观察[J].中国社区医师,2017,33(2):96-98.
[14]谢天维.康复新液联合益生菌应用于活动期轻中度溃疡性结肠炎的安全性及效果观察[J].医学信息,2016,29(26):149-150.
[15]常青霞.康复新液联合美沙拉嗪治疗溃疡性结肠炎疗效观察[J].中国实用医药,2016,11(33):136-137.
[16]董青.康复新液灌肠联合美沙拉嗪治疗溃疡性结肠炎疗效观察[J].中国中西医结合消化杂志,2011,19(4):252-253.
[17]周文博,曾宏翔,林震群.康复新液联合美常安及柳氮磺吡啶治疗溃疡性结肠炎疗效观察[J].医药前沿,2013(30):239.
[18]赵丽丽.康复新液灌肠联合美沙拉嗪治疗溃疡性结肠炎的疗效评价[J].世界最新医学信息文摘,2015,15(57):116-117.
[19]Jiang LY,Liu X,Xia CL,et al.Research advance on chemical constituents and anti-tumor effects of periplaneta americana L[J].Medicinal Plant,2012,5:95-97.
[20]郑重,陈维雄,陈尼维,等.康复新液对急性大鼠实验性结肠炎作用机制的研究[J].胃肠病学,2008,13(1):31-34.
[21]张春林.康复新液治疗溃疡性结肠炎鼠模型的疗效观察及机制初探[D].北京:中国协和医科大学北京协和医院,2015.
[22]苗政,钱家鸣,李景南,等.康复新液对小鼠噁唑酮结肠炎的疗效及其机制初探[J].胃肠病学,2012,17(8):457-461.
[23]陆允敏,金湧,陈维雄,等.康复新液治疗小鼠实验性结肠炎的研究[J].中国临床医学,2011,18(4):446-449.
[24]王朋川,何苗,张汉超,等.康复新液对2,4-二硝基氯苯联合醋酸诱导大鼠溃疡性结肠炎的影响[J].大理大学学报,2016,1(4):17-21.
[25]赵纯成,周钢,李远洪,等.益生菌制剂对溃疡型结肠炎患者血清炎性介质的影响[J].西南国防医药,2015,25(1):27-29.
[26]谢晶日,孙涛,张杨,等.益生菌在肠病中的应用及安全性[J].胃肠病学和肝病学杂志,2014,23(10):1113-1115.