健脾活血利水法治疗肝硬化腹水Meta分析

目的:系统评价依据中医鼓胀基本病理特点而确立的治法“健脾活血利水法”治疗肝硬化腹水的有效性及安全性。方法:计算机检索国内外数据库，收集健脾活血利水法治疗肝硬化腹水的随机对照研究，提取纳入文献数据并进行质量评价，利用Rev Man 5.4软件对数据进行Meta分析。结果:纳入21项研究，共1906例患者。Meta分析显示：与单纯西医常规治疗相比，联合健脾活血利水法在提升肝硬化腹水临床总有效率OR=4.02,95%CI(3.04,5.30),P<0.00001],改善24 h尿量MD=256.18,95%CI(164.00,348.36),P<0.00001]、腹围MD=-4.22,95%CI(-5.15,-3.29),P<0.00001]、腹腔积液深度MD=-0.52,95%CI(-0.67,-0.36),P<0.00001]方面均显示出优势，而在改善体重方面MD=-1.28,95%CI(-4.26,1.70),P=0.40]差异无统计学意义。结论:在治疗肝硬化腹水方面，健脾活血利水法联合西医常规疗法，能够有效改善临床症状，增加24 h尿量，减少腹围和腹...

A Meta-analysis of the basic treatment of Jianpi Huoxue Lishui method in the treatment of ascites in cirrhosis

Objective:To systematically evaluate the efficacy and safety of the treatment based on basic pathological characteristics of traditional Chinese medicine “Jianpi Huoxue Lishui” method combined with conventional western medicine in the treatment of ascites due to cirrhosis.Methods:Databases domestic and abroad were searched by computer to collect randomised controlled studies on the treatment of liver cirrhosis with ascites by strengthening the spleen,promoting blood circulation and diverting water.The included literature was extracted and the quality of the data was evaluated.Rev Man 5.4 software was used to carry out Meta-analysis of the data.Results:21 studies were included,with a total of 1906 patients.Meta-analysis showed that compared with conventional western medicine treatment alone,combined with the method of strengthening the spleen and promoting blood circulation and diuresis in improving the total clinical effective rate of liver cirrhosis ascites OR=4.02,95%CI(3.04,5.30),P<0.00001],improved 24 h urine output MD=256.18,95%CI(164.00,348.36),P<0.00001],abdominal circumference MD=-4.22,95%CI(-5.15,-3.29), P<0.00001],depth of ascites MD=-0.52,95%CI(-0.67,-0.36),P<0.00001] all showed advantages,while in terms of weight improvement MD=-1.28,95%CI(-4.26,1.70),P=0.40] no significant difference.Conclusion:The method of Jianpi Huoxue Lishui method combined with conventional western medicine therapy in the treatment of liver cirrhosis ascites can effectively improve the clinical symptoms,increase the 24-hour urine volume,and reduce the abdominal circumference and the depth of ascites.