[1]殷江龙 彭卓嵛 陈楚琴 石林韬 封秋毫 黄梦玲 陈月桥 李桂贤.益气健脾和胃法治疗慢性萎缩性胃炎的Meta分析[J].大众科技,2023,25(1):106-112.
 Meta-Analysis on the Treatment of Chronic Atrophic Gastritis with the Method of Invigorating Qi and Strengthening Spleen and Stomach[J].Popular Science & Technology,2023,25(1):106-112.
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益气健脾和胃法治疗慢性萎缩性胃炎的Meta分析()
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《大众科技》[ISSN:1008-1151/CN:45-1235/N]

卷:
25
期数:
2023年1
页码:
106-112
栏目:
医药与卫生
出版日期:
2023-01-20

文章信息/Info

Title:
Meta-Analysis on the Treatment of Chronic Atrophic Gastritis with the Method of Invigorating Qi and Strengthening Spleen and Stomach
作者:
殷江龙1 彭卓嵛2 陈楚琴1 石林韬1 封秋毫2 黄梦玲2 陈月桥2 李桂贤2
(1.广西中医药大学研究生院,广西 南宁 530222; 2.广西中医药大学第一附属医院,广西 南宁 530022)
关键词:
益气健脾和胃法慢性萎缩性胃炎Meta分析
Keywords:
method of invigorating qi and strengthening spleen and stomach chronic atrophic gastritis Meta-analysis
文献标志码:
A
摘要:
目的:系统评价益气健脾和胃法在治疗慢性萎缩性胃炎(Chronic atrophic gastritis,CAG)的安全性和有效性。方法:中文文献检索CNKI、Wan Fang Data、VIP、CBM;外文文献检索PubMed、Cochrane library数据库,收集自建库至2021年12月所有严格符合纳入标准的益气健脾和胃法治疗CAG的随机对照试验,运用RevMan 5.3软件对主要的结局指标进行Meta分析操作。结果:纳入22篇随机对照文献,总共有样本量1912名,其中实验组有974例样本量,对照组有938例样本量。Meta分析结果显示:实验组与对照组相比,在临床有效率(OR=5.06,95%CI[3.72,6.89],P<0.05)、Hp转阴率(OR=3.72,95%CI[2.18,6.35],P<0.05)、降低不良反应发生率(OR=0.3[0.17,0.56],P<0.05)方面均优于对照组,在改善中医症状总积分(MD=-2.5,95%CI[-3.27,-1.74],P<0.05)、胃脘疼痛(MD=-0.72,95%CI[-1.13,-0.32],P<0.05)、胃脘胀满(MD=-0.71,95%Cl[-0.97,-0.45],P<0.05)、嗳气泛酸(MD=-0.35,95%CI[-0.53.-0.17],P<0.05)、饮食减少(MD=-0.44,95%CI[-0.71,-0.16],P<0.05),实验组与对照组相比,均有所下降;在胃镜病理(MD=-3.12,95%CI[-4.97,-1.27],P<0.05),实验组优于对照组;在血清指标方面,对PG I、PG II及PGR方面,实验组都优于对照组。结论:益气健脾和胃法联合西药治疗慢性萎缩性胃炎,与单纯西药治疗相比,在临床总有效率、胃镜病理有效率及Hp转阴率方面,均能显著提高,且不良反应发生少,在改善中医总症状积分、胃脘胀满、胃脘疼痛、嗳气泛酸、饮食减少等反面均优于单纯西药,安全可靠。但由于本Meta分析原始文献质量偏低、偏倚风险较高,影响了结果的准确性和真实性。
Abstract:
Objective: To systematically evaluate the safety and effectiveness of the method of invigorating qi and strengthening spleen and stomach in the treatment of chronic atrophic gastritis (CAG). Methods: Chinese literature search CNKI, Wan Fang Data, VIP, CBM Foreign literature search PubMed and Cochrane library databases, collect all randomized controlled trials of supplementing qi and strengthening spleen and stomach therapy for CAG that strictly meet the inclusion criteria from the establishment of the database to December 2021, and use RevMan 5.3 software to perform Meta-analysis on the main outcome indicators. Results: 22 randomized controlled literatures were included, with a total sample size of 1912, including 974 samples in the experimental group and 938 samples in the control group. Meta-analysis results showed that: compared with the control group, the experimental group was superior to the control group in clinical efficiency (OR = 5.06, 95% CI (3.72, 6.89], P < 0.05), Hp overcast rate (OR = 3.72, 95% CI (2.18, 6.35], P <0.05), adverse reaction rate (OR=0.3[0.17,0.56], P<0.05), total score of TCM symptoms (MD=-2.5,95%CI[-3.27,-1.74], P<0.05), epigastric pain (MD=-0.72,95%CI[-1.13,-0.32], P<0.05), stomach fullness (MD=-0.71, 95%Cl[-0.97, -0.45], P<0.05), belching pantothenic acid (MD=-0.35, 95%CI[-0.53.-0.17], P<0.05), and diet reduction (MD=-0.44,95%CI[-0.71, -0.16], P<0.05), were all decreased in the experimental group compared with the control group In gastroscopic pathology (MD=-3.12, 95%CI[-4.97, -1.27], P<0.05), the experimental group was superior to the control group. In terms of serum indicators, the experimental group was superior to the control group in terms of PG I, PG II and PGR. Conclusion: The method of replenishing qi and strengthening spleen and stomach combined with western medicine in the treatment of chronic atrophic gastritis can significantly improve the clinical total effective rate, the pathological effective rate of gastroscopy and the negative rate of Hp compared with the simple western medicine, and has fewer adverse reactions. It is safer and more reliable than the simple western medicine in improving the total symptom score of traditional Chinese medicine, gastric distension, epigastric pain, belching and pantothenic acid, and diet reduction. However, due to the low quality of the original literature and the high risk of bias, the accuracy and authenticity of the results are affected.

参考文献/References:

[1] 李军祥,陈誩,吕宾,等. 慢性萎缩性胃炎中西医结合诊疗共识意见(2017年)[J]. 中国中西医结合消化杂志,2018,26(2): 121-131. [2] DINIS-RIBWIRO M, AREIA M, DE VRIES A C, et al. Management of precancerous conditions and lesions in the stomach (MAPS): Guideline from the European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter Study Group (EHSG), European Society of Pathology (ESP), and the Sociedade Portuguesa de Endoscopia Digestiva (SPED)[J]. Endoscopy, 2012, 44: 74-94. [3] CORREA P L, PIAZUELO M B. The gastric precancerous cascade[J]. Digestive Diseases, 2012, 13(1): 2-9. [4] CRAFA P, RUSSO M, MIRAGLIA C, et al. From Sidney to OLGA: An overview of atrophic gastritis[J]. Acta Bio Medica, 2018, 89(8S): 93-99. [5] RODRIGUEZ-CASTRO K I, FRAMCESCHI M, NOTO A, et al. Clinical manifestations of chronic atrophic gastritis[J]. Acta Bio Medica, 2018, 89(8S): 88-92. [6] 魏玮,杨洋,史海霞. 慢性萎缩性胃炎中医诊疗现状、挑战及展望[J]. 中国中西医结合杂志,2015,35(12): 1424-1426. [7] 黄伟,单兆伟. 单兆伟治疗慢性萎缩性胃炎及癌前病变经验浅识[J]. 中国民间疗法,2021,29(18): 28-31. [8] 尹丹,许丹彤. 慢性萎缩性胃炎患者采用中西医结合治疗的临床价值研究[J]. 系统医学,2021,6(10): 125-127. [9] 王飞. 益气健脾汤联合西药治疗慢性萎缩性胃炎临床疗效观察[J]. 内蒙古医学杂志,2021,53(1): 75-76. [10] 赵劲枝,周玉梁. 四君子汤合失笑散治疗慢性萎缩性胃炎临床观察[J]. 光明中医,2021,36(22): 3813-3816. [11] 贾靖,徐甜甜,张毅,等. 健脾益气方治疗慢性萎缩性胃炎临床疗效[J]. 中国中西医结合消化杂志,2021,29(8): 575-579. [12] 谢志刚,陈敏,谭梅桂,等. 四君子汤加减联合雷贝拉唑治疗慢性萎缩性胃炎的效果分析[J]. 齐齐哈尔医学院学报,2020,41(24): 3058-3060. [13] 赵文,郭师,王同单. 益气健脾汤联合西药治疗慢性萎缩性胃炎临床研究[J]. 新中医,2020,52(6): 14-16. [14] 李宁. 香砂六君子汤对慢性萎缩性胃炎患者氧化应激及PGⅠ、PGⅡ的影响[J]. 现代医学与健康研究电子杂志,2020,4(13): 74-76. [15] 陈丽丽. 香砂六君子汤联合西药治疗慢性萎缩性胃炎临床观察[J]. 光明中医,2019,34(18): 2834-2836. [16] 谢铭. 四君子汤加味联合常规西药治疗慢性萎缩性胃炎临床研究[J]. 新中医,2019,51(10): 74-77. [17] 张方,康传哲,胡晓艺,等. 香砂六君丸联合泮托拉唑治疗慢性萎缩性胃炎的疗效观察[J]. 中国医院用药评价与分析,2019,19(7): 832-833,837. [18] 崔力. 六君子汤加减治疗慢性萎缩性胃炎(脾胃虚弱证)对患者症状改善、胃肠功能及疗效影响分析[J]. 中医临床研究,2019,11(8): 42-44. [19] 罗曼虹. 加减香砂六君子汤联合三联疗法治疗慢性萎缩性胃炎临床观察[J]. 广州医药,2019,50(1): 28-32. [20] 李玉宝. 四君子汤加减联合雷贝拉唑治疗慢性萎缩性胃炎的临床观察[J]. 中医临床研究,2019,11(25): 70-72. [21] 马业平,顾广富,柯大伟,等. 四君子汤加减联合雷贝拉唑治疗慢性萎缩性胃炎的临床效果分析[J]. 糖尿病天地,2019(12): 24. [22] 张建军,陈小菲. 四君子汤加减治疗慢性萎缩性胃炎的疗效观察[J]. 中国民康医学,2018,30(10): 69-70,81. [23] 李岩,柏树纲. 六君子汤联合西药治疗脾胃虚弱型慢性萎缩性胃炎疗效观察[J]. 内蒙古中医药,2016,35(14): 76-77. [24] 高俊红,谭国良. 益气健脾汤联合三联疗法用于82例慢性萎缩性胃炎临床观察[J]. 中医临床研究,2016,8(16): 17-19. [25] 卢炯. 六君子汤加味联合西药对慢性萎缩性胃炎患者胃功能的影响[J]. 新中医,2015,47(12): 51-53. [26] 周文锋. 柴胡疏肝散合四君子汤治疗慢性萎缩性胃炎47例[J]. 中国中医药现代远程教育,2013,11(22): 29. [27] 冯宗平. 香砂六君子汤加减联合西药治疗慢性萎缩性胃炎42例[J]. 中医药导报,2011,17(6): 106-107. [28] 王木生,熊锋宝. 加味香砂六君子汤治疗慢性萎缩性胃炎的疗效观察[J]. 实用临床医学,2008(3): 40-41. [29] 杨桦,王顺兴. 中西医结合治疗慢性萎缩性胃炎并幽门螺杆菌感染47例[J]. 新中医,2001(9): 41-42. [30] LAHNER E, ZAGARI R M, ZULLO A, et al. Chronic atrophic gastritis: Natural history, diagnosis and therapeutic management[J]. Digestive and Liver Disease, 2019, 51(12): 1621-1632. [31] 王雷生,李志刚. 李郑生教授辨治慢性萎缩性胃炎经验总结[J]. 河南医学研究,2021,30(18): 3408-3410.

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备注/Memo

备注/Memo:
【收稿日期】2022-09-15 【基金项目】国家自然科学基金地区科学基金项目(82160888);国家中医药管理局全国名老中医药专家李桂贤传承工作室建设项目(国中医药人教发〔2016〕42号);广西中医药管理局科研项目(GXZYY20210336);广西中医药大学校级自然科学面上项目(2021MS029)。 【作者简介】殷江龙(1995-),男,江西九江人,广西中医药大学研究生院在读硕士研究生,从事中西医结合消化系统疾病临床研究;彭卓嵛(1974-),女,广西中医药大学第一附属医院主任医师,硕士,研究方向为中西医结合防治消化系统疾病。
更新日期/Last Update: 2023-03-30