参苓白术散联合西药治疗溃疡性结肠炎的Meta分析

发布时间：2018-12-16 12:18

【摘要】：目的采用循证医学的方法,系统评价参苓白术散联合西药治疗溃疡性结肠炎的临床疗效,科学了解目前的治疗状况,为今后临床治疗溃疡性结肠炎提供科学的参考价值。方法计算机检索中国知网(1982-2015)、万方(2001-2015)、维普(1989-2015)、读秀(1996-2015)、PUBMED(1991-2015)、PLoS公共医学科学图书馆(1991-2015)、PMC美国国家医学图书馆生命科学期刊(1991-2015)等数据库,收集有关参苓白术散联合西药治疗溃疡性结肠炎的临床随机对照试验(RCT),由2位评价者按照Cochrane系统评价方法,从随机方法、盲法的运用、样本含量、治疗方法、统计学方法、随访与失访等内容独立地进行文献的筛选、资料提取与质量评价,采用RevMan5.3统计软件进行Meta分析。结果初检出相关文献558篇,剔除重复发表及无数据可用的文献后获得185篇。通过阅读标题和摘要及全文,最终纳入10篇进入meta分析,共884例,其中治疗组(口服参苓白术散联合西药治疗)447例,对照组(口服常规西药治疗)437例。10个研究的总有效率、显效率、无效率研究异质性不明显,采用固定效应模型进行Meta分析,参苓白术散联合西药组在治疗溃疡性结肠炎的总有效率[OR=3.30,95%CI(2.25,4.82),P0.01]、显效率[OR=2.02,95%CI(1.54,2.65),P0.01]均优于对照组,有效率与对照组相近[OR=1.08,95%CI(0.78,1.50),P=0.64],无效率则低于对照组[OR=0.30,95%CI(0.21,0.44),P0.01],差异有显著统计学意义;1个研究进行了复发率比较,治疗组复发率19.4%;对照组复发率50.0%,两组比较有显著性差异(χ2=5.35,P0.05)。漏斗图分析不对称,表明存在发表性偏倚。结论参苓白术散联合西药疗法治疗溃疡性结肠炎的疗效与常规西药疗法相比,具有疗效优势。受纳入研究质量与数量限制,因此上述结论仍待更多高质量、大样本的临床随机对照研究进一步验证。
[Abstract]:Objective to evaluate the clinical effect of Shenling Atractylodes Powder combined with western medicine in the treatment of ulcerative colitis by using the method of evidence-based medicine, to scientifically understand the current treatment situation and to provide scientific reference value for clinical treatment of ulcerative colitis in the future. Methods A computer search was conducted on China Zhiwang (1982-2015), Wanfang (2001-2015), Weipu (1989-2015), PLoS (1996-2015), PUBMED (1991-2015) and), PLoS Public Medical Science Library (1991-2015). PMC National Library of Medical Sciences Journal of Life Sciences (1991-2015) and other databases collected the clinical randomized controlled trial (RCT),) related to the treatment of ulcerative colitis with Shenling Atractylodes powder combined with western medicine. Two evaluators evaluated (RCT), according to the Cochrane system. The random method, blind method, sample size, treatment method, statistical method, follow-up and lost visit were used to screen the literature, extract the data and evaluate the quality independently. The Meta analysis was carried out by RevMan5.3 statistical software. Results A total of 558 literatures were initially identified, and 185 articles were obtained after repeated publication and no data were available. By reading the title, abstract and full text, 10 articles were included in the meta analysis, including 447 cases in the treatment group (oral Shenling Baizhu Powder combined with western medicine). In the control group, 437 cases were treated by oral routine western medicine. The total effective rate, and inefficiency of 10 studies were not obvious. The fixed effect model was used for Meta analysis. The total effective rate [OR=3.30,95%CI (2.254.82), P0.01] and the effective rate [OR=2.02,95%CI (1.54 卤2.65), P0.01] of Shenling Baizhu Powder combined with western medicine group were better than those of the control group. The effective rate was similar to that of the control group [OR=1.08,95%CI (0.78U 1.50), P < 0.64], but the ineffective rate was lower than that of the control group [OR=0.30,95%CI (0.21 卤0.44), P0.01]. The difference was statistically significant. In one study, the recurrence rate was 19.4g in the treatment group and 50.0 in the control group. There was a significant difference between the two groups (蠂 2, 5.35, P0.05). The analysis of asymmetry by funnel graph indicates that there is a published bias. Conclusion the curative effect of Shenling Baizhu Powder combined with western medicine in the treatment of ulcerative colitis is superior to that of routine western medicine. Limited by the quality and quantity of the included studies, the above conclusions need to be further verified in a large sample of randomized controlled clinical trials with more high quality.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R574.62

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