| 张平,项凤梅,胡子毅,李人亮.四君子汤类方治疗消化性溃疡有效性meta分析[J].实用中西医结合临床,2021,21(1): |
| 四君子汤类方治疗消化性溃疡有效性meta分析 |
| The effectiveness of Sijunzi Decoction in the treatment of peptic ulcer:a Meta-analysis |
| 投稿时间：2020-08-22 修订日期：2020-09-08 |
| DOI： |
| 中文关键词: 四君子汤 香砂六君子汤 参苓白术散 消化性溃疡 系统评价 meta分析 |
| 英文关键词: Sijunzi Decoction Xiangsha Liujunzi Decoction Shenling Baizhu powder peptic ulcer Meta analysis |
| 基金项目:江西省中医药中青年骨干人才培养计划（赣中医药科教字[2020]2号）; 江西省卫生计生委中医药科研课题，国医大师伍炳彩教授治疗消化性溃疡临证经验及学术思想传承研究（2018A081） |
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| 中文摘要: |
| 目的：系统评价四君子汤类方治疗消化性溃疡的临床疗效。方法： 计算机检索中国知网（CNKI）、万方数据库（WanFang）、维普数据库（VIP）、中国生物医学文献数据库（CBM）四大中文数据库四君子汤类方治疗消化性溃疡的所有随机对照试验（RCTs），检索时限为建库至 2020 年 3月。 全面收集及追溯纳入研究的文献，根据纳入排除标准筛选文献并提取相关数据，采用 RevMan 5.3 软件对数据进行 Meta 分析。结果：共纳入22个RCT,总计2748例患者，涉及四君子汤、香砂六君子汤、参苓白术散3个方剂。Meta分析结果显示：在临床总有效率方面，单用中药组治疗消化性溃疡优于对照组（OR=3.60，95%CI：2.06~6.30，P<0.05）；中西医结合治疗组治疗消化性溃疡优于对照组（OR=3.68,95%CI:2.73~4.96,P<0.05）。在Hp根除率方面，香砂六君子汤联合西药治组优于对照组OR=4.59,95%CI（2.39,8.79），P<0.05。 在减少复发率方面，治疗组溃疡复发率低于对照组（治疗后6个月OR=0.24,95%CI：0.13~0.42，P<0.05；治疗后1年OR=0.27,95%CI：0.16~0.45，P<0.05）。不良反应发生率方面，治疗组的不良反应事件发生率低于对照组（OR=0.32,95%CI：0.21~0.50，P<0.05）。结论：与单纯西药治疗相比，四君子汤类方单用或联合西药辅助治疗消化性溃疡在临床疗效、预防溃疡复发、减少西药不良反应方面的疗效可能更佳，但仍需要更多的高质量研究加以证实。 |
| 英文摘要: |
| Objective: To systematically evaluate the clinical effect of Sijunzi Decoction in the treatment of peptic ulcer.Methods: Four Chinese databases（CNKI, Wanfang, VIP and CBM）were searched by computer for RCTs of Sijunzi Decoction in the treatment of peptic ulcer. The retrieval time limit is from the establishment of the database to March 2020. According to the inclusion and exclusion criteria, the literature was screened and data was extracted and given methodlogical quality evaluation. The data was given a Meta-analysis by using RevMan 5.3 software.Results: Totally 22 RCTs involving 2748 patients were included in the study,and involving three prescriptions of Sijunzi Decoction, Xiangsha Liujunzi Decoction and Shenling Baizhu powder. The results of meta analysis showed that：in terms of clinical total effective rate, the traditional Chinese medicine group was superior to the control group (OR= 3.60, 95% CI: 2.06 ~ 6.30, P < 0.05); the integrated Chinese and Western medicine group was superior to the control group (OR= 3.68, 95% CI: 2.73 ~ 4.96, P < 0.05). In terms of HP eradication rate, Xiangsha Liujunzi Decoction Combined with western medicine treatment group was better than the control group (OR= 4.59,95% CI (2.39,8.79), P < 0.05). In terms of reducing the recurrence rate, the recurrence rate of ulcer in the treatment group was lower than that in the control group (OR= 0.24, 95% CI: 0.13-0.42, P < 0.05 at 6 months after treatment, and OR= 0.27, 95% CI: 0.16-0.45, P < 0.05, at 1 year after treatment). The incidence of adverse events in the treatment group was lower than that in the control group (or = 0.32, 95% CI: 0.21-0.50, P < 0.05).Conclusion: Compared with western medicine alone, Sijunzi Decoction alone or combined with western medicine may be more effective in the treatment of peptic ulcer in terms of clinical efficacy, prevention of ulcer recurrence and reduction of adverse reactions of Western medicine, but it still needs more high-quality research to confirm. |
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