小陷胸汤及其加减方治疗胃食管反流疾病临床随机对照试验的系统评价

目的:系统评价国内小陷胸汤及其加减方治疗胃食管反流疾病的疗效,为其方治疗该病的推广应用提供理论依据。方法:搜集小陷胸汤及其加减方治疗临床随机对照试验文献,选择合格研究,应用Jadad评分法进行质量评价,运用异质性检验、Meta-分析、漏斗图分析等方法统计数据。结果:检索到符合纳入标准的临床对照试验文献11篇。Jadad评分普遍不高。纳入10项研究中:总有效率OR合并=3.58,其95%CI为(2.49,5.14)。可认为小陷胸汤及其加减方治疗胃食管反流疾病相对对照组而言有效。纳入4项研究中:一年复发率RR合并=0.36,其95%CI为(0.18,0.72)。可认为小陷胸汤及其加减方降低胃食管反流疾病一年复发率方面相对对照组而言更有效。总有效率纳入研究的漏斗图分析结果良好。结论:小陷胸汤及其加减方治疗胃食管反流疾病在总有效率方面相对对照组而言有效,特别是对比雷尼\法莫替丁、吗丁啉,无效研究对照组均含有奥美拉唑,在降低胃食管反流疾病一年复发率方面相对对照组而言更有效。加大该方比照雷尼/法莫替丁、吗丁啉的疗效研究,同时完善有效率指标、不良反应等的报道,重视对复发率的跟踪报道。

System Evaluation for Randomized Clinical Trials of Gastroesophageal Reflux Disease Treated by Xiao Xianxiong Decoction and its Variation Formula

Objective:To evaluate curative effect of gastroesophageal reflux disease treated by Xiao Xianxiong Decoction and its variation formula in internal trials.Method:To gather with randomized clinical trials of gastroesophageal reflux disease treated by Xiao Xianxiong Decoction and its variation formula,and to select qualified trials.Jadad score was used to assess the quality of RCT.Heterogeneity test,Meta-analyses,funnel plot were used for statistical data.Results:RCTs according with internalize standard are 11.The score of RCTs are not high.10 qualified trials:total effective rate OR \3.58,95%CI(2.49,5.14) \].So we think the curative effect of gastroesophageal reflux disease treated by Xiao Xianxiong Decoction and its variation formula is more the the control group.Racurrence rate in one year RR\0.36,95% CI(0.18,0.72)\].So we think decreasing recurrence rate in one year of gastroesophageal reflux disease treated by Xiao Xianxiong Decoction and its variation formula is more the the control group.Funnel plot of qualified trials is good in total effective rate.Conclusion:The curative effect of gastroesophageal reflux disease treated by Xiao Xianxiong Decoction and its variation formula is more the the control group in total effective rate.Especially,contrasting famotidine,ranitidine,domperidone.Ineffective trails contain omeprazole.Decreasing recurrence rate in one year of Xiao Xianxiong Decoction and its variation formula is more useful.In a word we should expand study of Xiao Xianxiong Decoction and its variation formula contrasting famotidine,ranitidine,domperidone.And improve total effective rate,add adverse effect,recurrence rate.