白头翁汤加减联合美沙拉嗪治疗溃疡性结肠炎的Meta分析

目的系统评价白头翁汤加减联合美沙拉嗪治疗溃疡性结肠炎的临床疗效。方法计算机检索国内外相关数据库,收集以美沙拉嗪为对照,观察白头翁汤加减联合美沙拉嗪治疗溃疡性结肠炎的随机对照试验(RCT)报告,检索时间均从建库至2017年12月;由两名研究人员独立进行文献筛选、资料提取、质量评价,采用Rev Man5.3和Stata软件进行Meta分析。结果共纳入12篇RCT文献(涉及842例患者)。Meta分析结果显示,对比单用美沙拉嗪,白头翁汤加减联合美沙拉嗪有更好的综合疗效[RR=1.23,95%CI(1.16,1.30),Z=6.74,P0.01]和肠镜下黏膜疗效[RR=1.28,95%CI(1.01,1.63),Z=2.04,P0.05],可更好地改善腹痛[WMD=-0.69,95%CI(-1.37,-0.01),Z=1.98,P=0.05]和脓血便症状[WMD=-0.55,95%CI(-0.63,-0.48),Z=14.17,P0.01];在改善腹泻症状方面,两者差异无统计学意义(P0.05)。结论对比单用美沙拉嗪,白头翁汤联合美沙拉嗪治疗溃疡性结肠炎有更好的综合疗效和肠镜下黏膜疗效,对腹痛和脓血便的改善效果也优于单用美沙拉嗪;但由于纳入文献的质量偏低,上述结论有待高质量研究进一步验证。

Modified Baitouweng Decoction combined with mesalazine in the treatment of ulcerative colitis:A Meta-analysis

  Objective:To systematically evaluate the clinical efficacy of Baitouweng Decoction combined with mesalazine in the treatment of ulcerative colitis. MethodsDatabases were searched from database creation to December 2017 to collect the randomized controlled trials(RCT) reports about Baitouweng Decoction combined with mesalazine in treating ulcerative colitis which compared with mesalazine. The literature screening,data extraction and quality evaluation were conducted independently by two researchers. The Meta-analysis was conducted by RevMan 5.3 and Stata software.  Results:A total of 12 RCT literatures involving 842 patients were included. The results of Meta-analysis showed that Baitouweng Decoction combined with mesalazine showed better comprehensive efficacy and endoscopic mucosal efficacy compared with mesalazine. It also showed better improvement on symptoms such as abdominal pain and bloody purulent stool. However,no statistically significant difference on improvement of diarrhea was observed(P>0.05).  Conclusion: Compared with mesalazine alone,Baitouweng Decoction combined with mesalazine shows better comprehensive efficacy and endoscopic mucosal efficacy in the treatment of ulcerative colitis,and the improvement effects on abdominal pain and bloody purulent stool are also better than mesalazine alone. However,due to the low quality of the included literatures,the above conclusion needs further verification by high quality studies.