针灸结合中药治疗胃食管反流病的系统评价和Meta分析

目的]对针灸结合中药治疗胃食管反流病的研究进行系统评价与Meta分析,探讨针灸结合中药对胃食管反流病的临床疗效。方法]电脑检索Cochrane Library、PubMed、中国知网(CNKI)、维普(VIP)、万方数据库(WANFANG)。从建库至2017年10月所收录的相关随机对照试验/半随机对照试验,利用Cochrane 5.1.0提供的标准对纳入的研究进行质量评价与风险评估,使用Revman 5.3软件进行针灸结合中药治疗胃食管反流病的有效率、复发率、血浆胃动素(MOT)、症状积分进行统计分析。结果]总计纳入18篇文献,Meta分析结果显示:1)针灸结合中药治疗胃食管反流病总有效率高于西药组OR=3.14,95%CI(2.24,3.40),P0.01]。2)针灸结合中药治疗胃食管反流病复发率低于西药组OR=0.31,95%CI(0.14,0.68),P0.01]。3)患者血浆MOT提升方面,针灸结合中药优于西药组SMD=61.02,95%CI(44.18,77.87),P0.01]。4)患者症状积分改善方面,针灸结合中药组优于西药组SMD=2.99,95%CI(1.58,4.39),P0.01]。结论]在总有效率、复发率、症状改善、血浆MOT方面,针灸结合中药疗效肯定。

Systematic evaluation and Meta-analysis of acupuncture combined with traditional Chinese medicine in the treatment of gastroesophageal reflux disease

Objective] Acupuncture combined with Chinese medicine in the treatment of gastroesophageal reflux disease were systematically evaluated and Meta-analysis to explore the clinical efficacy of acupuncture combined with Chinese medicine on gastroesophageal reflux disease.Methods] The documents were searched from Cochrane Library, PubMed, CNKI, VIP and WANFANG. The relevant randomized controlled trial/semi-randomized controlled trial were collected from the first year that the database was established to October 2017. The quality evaluation and risk assessment of the inclusion were carried out using the criteria provided by the Cochrane5.1.0, and the effective rate, recurrence rate, plasma mot and symptom score of the treatment of gastroesophageal reflux disease were statistically analyzed by using the Revman 5.3 software.Results] A total of 18 articles were included. The meta-analysis showed that:1) The total effective rate of acupuncture and moxibustion combined with Chinese medicine in the treatment of gastroesophageal reflux disease was higher than that of Western medicine group(OR=3.14,95% CI2.24,3.40],P<0.01). 2)The recurrence rate of gastroesophageal reflux disease treated by acupuncture combined with Chinese medicine was lower than that of western medicine group(OR=0.31,95% CI0.14,0.68],P<0.01);(3)The improvement of plasma MOT in patients with acupuncture and moxibustion combined with Chinese medicine is superior to Western medicine (SMD=61.02,95% CI44.18,77.87],P<0.01). 4) Patients with symptom score improvement, acupuncture combined with Chinese medicine group was better than Western medicine group(SMD=2.99,95% CI1.58,4.39],P<0.01).Conclusion] In the aspects of total effective rate, recurrence rate, symptom improvement and plasma MOT, acupuncture combined with Chinese medicine is effective.