基于“虚瘀毒”理论的中医药治疗慢性萎缩性胃炎的Meta分析

目的系统评价在"虚瘀毒"中医理论指导下治疗慢性萎缩性胃炎的疗效及安全性。方法计算机检索知网、万方、维普、PubMed数据库,收集自建库至2018年9月在"虚瘀毒"中医理论指导下治疗CAG的随机对照试验,依制定的筛选标准确定纳入文献。采用RevMan 5.3软件进行文献相关风险评估及meta分析。结果纳入29项RCT,共2475例患者,其中"虚瘀毒"治疗组1297例,对照组1178例。与对照组相比,"虚瘀毒"组能提高临床总有效率(RR=1.34,95%CI[1.29,1.40],P<0.05)及胃镜有效率(RR=1.34,95%CI(1.23,1.47),P<0.05);降低不良反应发生率(RR=0.16,95%CI[0.05,0.52],P<0.05)。结论中医"虚瘀毒"理论指导下治疗CAG,能显著提高临床有效率及胃镜有效率、明显改善胃黏膜病理改变,且不良反应发生少,安全可靠。然鉴于所纳入文献的局限性,此结论尚需进一步多中心、大样本的随机对照临床试验论证。

Meta-analysis on Treatment of Chronic Atrophic Gastritis with TCM Based on Theory of "Deficiency,Blood Stasis and Toxin"

Objective To systematically evaluate the clinical efficacy and safety of the treatment of chronic atrophic gastritis(CAG)under the guidance of TCM theory of"deficiency,blood stasis and toxin".Methods Randomized controlled trials about the TCM treatment of CAG based on the theory of"deficiency,blood stasis and toxin"in CNKI,Wanfang,Wepu and PubMed were retrieved by computer.The retrieval range was from the database establishing to September,2018.RevMan 5.3 supplied by The Cochrane Center was used for the risk assessment and Meta-analysis of the outcomes of included RCTs.Results A total of 29 randomized trials were finally enrolled which included 2475 patients by two groups:experimental group(n=1297)and control group(n=1178).Compared with the control group,"deficiency,blood stasis and toxin"group improved the total clinical effective rate[RR=1.34,95%CI(1.29,1.40),P<0.05]and the gastroscopic effective rate[RR=1.34,95%CI(1.23,1.47),P<0.05],reduced the incidence of adverse reactions[RR=0.16,95%CI(0.05,0.52),P<0.05].Conclusion Treatment of CAG under the guidance of the TCM theory of"deficiency,blood stasis and toxin"can significantly improve the clinical and gastroscopic efficiency,and improve the pathological changes of gastric mucosa,with fewer adverse reactions.It is safe and reliable.Yet,considering the quality of the literature,there must be more multicenter,large-sample randomized controlled clinical trials for validation.