黄芪建中汤加减治疗慢性萎缩性胃炎的Meta分析和试验序贯分析

目的:系统性评价黄芪建中汤加减治疗慢性萎缩性胃炎的临床疗效.方法:检索中国知网、万方、维普、PubMed、Embase、the Cochrane Library数据库中关于黄芪建中汤治疗慢性萎缩性胃炎的临床试验,时间范围从建库至2020年8月,筛选文献,提取资料,进行Meta分析和试验序贯分析.结果:共纳入10项研究,...

A Meta Analysis and an Experimental Sequential Analysis of Astragalus Center-Fortifying Decoction in the Treatment of Chronic Atrophic Gastritis

Objective:To systematically evaluate the clinical efficacy of Astragalus Center-Fortifying Decoction on chronic atrophic gastritis.Methods:The clinical experiments of Astragalus Center-Fortifying Decoction in the treatment of chronic atrophic gastritis in the databases of CNKI,Wanfang,VIP,PubMed,Embase and the Cochrane Library were searched.The time limit was from the establishment of the database to August 2020.The literature was screened,the data were extracted,and a Meta-analysis and an experimental sequence analysis were both carried out.Results:A total of 10 studies were included,including 1698 patients,with 849 cases in the experimental group and 849 cases in the control group.(1)The results of Meta-analysis showed that compared with conventional Western medicine,Astragalus Center-Fortifying Decoction could effectively improve the cure rate of clinical symptoms of chronic atrophic gastritisRR=2.25,95%CI=(1.17,4.34),(P=0.01)],the cure rate of gastroscopyRR=2.25,95%CI=(1.17,4.34),(P=0.01)],the effective rate of clinical symptomsRR=1.23,95%CI=(1.17,1.30),(P<0.00001)]and the effective rate of gastroscopyRR=1.21,95%CI=(1.14,1.29),(P<0.00001)],and can reduce the recurrence rateRR=0.20,95%CI=(0.05,0.88),(P=0.03)].(2)The experimental sequential analysis showed that the cumulative Z value of the effective rate of clinical symptoms crossed the TSA boundary value in the third experiment,which could be used as definite evidence.(3)In terms of publication bias,the Harbor test of effective clinical symptoms showed that there was no significant publication bias(P=0.11).(4)In terms of evidence quality evaluation,the evidence quality of clinical symptom effective rate and gastroscopy effective rate were low.The evidence quality of clinical symptom cure rate,the gastroscopy cure rate and the recurrence rate were extremely low,and all the recommendation intensity was weak.Conclusion:Astragalus Center-Fortifying Decoction is better than conventional Western medicine in the treatment of chronic atrophic gastritis,but more evidence-based medicine is needed in the future.