辛开苦降法治疗慢性萎缩性胃炎临床疗效的荟萃分析

目的比较以辛开苦降立法之中药组方与单纯西药治疗慢性萎缩性胃炎的临床疗效。方法通过制定随机对照高敏感性检索策略和对国内主要数据库检索（不考虑盲法，语言为中文和英文），两名评价人员分别根据纳入标准和剔除排除标准对检索的随机对照试验进行3次独立筛选和对所纳入研究进行有效的数据提取，并分别对文献质量进行科学评价，最终经核对一致的数据进行统计合并，根据异质性分析选用固定效应模式或随机效应模式进行系统分析。结果共4篇267例随机对照实验纳入研究，辛开苦降法的总有效RR=1．31，95％CI（1．08，1．59），P=0．006]，愈显率RR=3．13，95％CI（1．78，5．50），P=0．096]，其中3项研究数据纳入幽门螺旋杆菌（Hp）根除情况RR=2．07，95％CI（0．74，5．83），P=0．17]。结论Meta分析显示符合辛开苦降立法的中药组方在临床疗效上优于单纯西药治疗，而Hp根除状况上尚不能认为优于单纯西药治疗；由于所纳入研究较少且部分研究为低质量偏倚风险不确定的随机对照研究，需高质量和低偏倚风险的研究进一步证实。

Meta-analysis on effect of chronic atrophic gastritis treated with Chinese herbal medicine based on the method of acrid opening and bitter descending

Objective To explore the effect of Chronic Atrophic Gastritis （CAG） treated between Chinese Herbal Medicine based on the method of acrid opening and bitter descending and purely western medicine. Methods After searching only randomized clinical trials comparing the purely Western Medicine between Chinese Herbal Medicine based on acrid opening and bitter descending with using hyper-sensibility specific strategy （ irrespective of blinding, searching with English and Chinese） , two authors independently identified the trials for exclusion and inclusion criterion after screening duplicate and irrelevant copies and reading article title and abstract and full text, and extracted the data and assessed the methodo- logical quality of the trials and risk of bias. After calculating the Relative Risk （RR） and 95% confidence intervals（ CI）, Meta-analysis was performed by RevMan 5.0 with fixed effects models or random effects models. Results 4 RCTs with 267 patients were included this review. There was statistically significant between two groups on overall effect RR = 1.31,95% CI（ 1.12, 1.54） ] and curative effect RR =2. 17, 95% CI（1. 49,3.14） ,P = 0. 0001 ]. There was no significant difference between two groups in eradicating HP RR = 1.53,95% CI（0. 88,2. 65） ,P =0. 13 ]. Conclusion The therapeutic effect of Chinese Herbal Medicine intervention of PLGC was thought to be significant over using the purely Western Medicine, but further randomized trials with high-quality and low-risked bias is needed.