三九胃泰制剂治疗慢性胃炎疗效与安全性的系统评价

[目的]系统评价三九胃泰治疗慢性胃炎的疗效与安全性。[方法]计算机检索中国期刊全文数据库(CNKI)、万方数据库、中国生物医学文献数据库(Sino Med)及美国国立医学图书馆(Pub Med)数据库,检索期限均从建库至2016年9月。收集三九胃泰治疗慢性胃炎的所有随机对照试验(RCT),两名评价者独立进行文献筛选与数据提取,采用Cochrane Handbook推荐的偏倚风险评价工具对纳入研究进行质量评价,争议通过讨论解决。[结果]检索到673条文献目录,按照纳入排除标准筛选后有8个研究纳入本研究,共614例患者。由于纳入研究间异质性较大,故未进行数据合并分析,采用描述性分析。结果显示,与奥美拉唑、替普瑞酮、得乐冲剂、麦滋林-S及抗菌素比较,三九胃泰在缓解腹痛、嗳气、反酸等临床症状方面与之疗效相当;与奥美拉唑、得乐冲剂比较,三九胃泰在修复胃黏膜损伤方面与之疗效相当。幽门螺旋杆菌清除率方面,三九胃泰的疗效不优于得乐冲剂。肠上皮化生变化及胃黏膜异型增生变化方面,三九胃泰疗效与麦滋林-S相当。安全性方面,三九胃泰组均未发生明显不良反应。[结论]三九胃泰制剂对于慢性胃炎具有一定疗效,但由于纳入的研究数量少、异质性大,且文献的方法学质量较低,三九胃泰治疗慢性胃炎的优势和特色还需要高质量的研究来阐明。

Systematic review on effect and safety of Sanjiu Weitai for chronic gastritis

[Objective] In this study, we evaluated the efficacy and safety of Sanjiu Weitai for chronic gastritis.[Methods] We searched CNKI, Wanfang Data, SinoMed and PubMed (before Sep 2016), and collected relevant randomized controlled trials (RCTs). Two authors independently performed screening the literature and data extraction, the quality of included references was evaluated according to criteria recommended by Cochrane Handbook and the disputes were resolved through discussion.[Results] A total of 673 articles were retrieved and 8 RCTs, including 614 patients were enrolled in this study according to the inclusion criteria. Because of a significant clinical heterogeneity among these studies, we finally performed descriptive analysis instead of data analysis. Sanjiu Weitai showed comparative efficacy in alleviating clinical symptoms including abdominal pain, belching, acid regurgitation and etc., compared to omeprazole, teprenone, bismuth potassium citrate granule, marzulene-S and antibiotics. In the clearance rate of Hp, the efficacy of Sanjiu Weitai is not so good as bismuth potassium citrate granule, but in restoring intestinal metaplasia and gastric mucosal hyperplasia, Sanjiu Weitai has a comparative efficacy with marzulene-S. When concerned with safety, no obvious adverse reactions were reported in the group of Sanjiu Weitai.[Conclusion] Sanjiu Weitai was effective for Chronic Gastritis. However, due to the limited number of eligible RCTs, significant heterogeneity and poor methodological quality, the advantages of Sanjiu Weitai in treating chronic gastritis need high quality RCTs to prove.