参苓白术散加减对比西药治疗溃疡性结肠炎的疗效和安全性Meta分析

发布时间：2018-12-30 20:05

【摘要】：通过探讨参苓白术散加减治疗溃疡性结肠炎(UC)的有效性和安全性,为临床推广提供科学依据。计算机检索CNKI,CBM,万方,维普等数据库,纳入参苓白术散加减对比单用西药治疗溃疡性结肠炎的随机对照试验文献(randomized control trials,RCTs),用Cochrane评价方法进行风险偏倚评估;收集纳入研究的有效率、主要症状(腹泻、腹痛、便脓血、发热)的改善时间和肠镜下黏膜疗效,并进行Meta分析。本研究共纳入13篇RCTs,总例数1 285例,参苓白术散组659例,单用西药组598例。对比单用西药,参苓白术散加减有较高临床疗效(RR=1.17,95%CI[1.13,1.22],P0.001),能明显缩短腹泻、腹痛、便脓血、发热症状的改善时间,其合并效应量分别为(RR=-12.32,95%CI[-14.27,-10.37],P0.001),(RR=-8.06,95%CI[-9.88,-6.24],P0.001),(RR=-9.89,95%CI[-10.77,-9.00],P0.001),(RR=-8.29,95%CI[-9.59,-6.98],P0.001),减少不良反应事件的发生(RR=0.06,95%CI[0.01,0.40],P=0.004)。参苓白术散加减治疗UC的肠镜下黏膜疗效比较没有统计学意义。对比单用西药,参苓白术散加减治疗溃疡性结肠炎有更好的疗效和安全性,适合临床推广使用,但由于纳入文献数目较少,质量较低,需要高质量的大样本双盲随机对照试验的支持。
[Abstract]:To explore the efficacy and safety of Shenling Atractylodes Powder in the treatment of ulcerative colitis (UC). To search the database of CNKI,CBM, Wanfang, Weipu and so on, add and subtract Shenling Atractylodes Powder (randomized control trials,RCTs), and evaluate the risk bias by Cochrane evaluation method, which is a randomized controlled trial literature on the treatment of ulcerative colitis with western medicine alone. The effective rate, the time of improvement of the main symptoms (diarrhea, abdominal pain, sepsis, fever) and the mucosal efficacy under colonoscopy were collected and analyzed by Meta. In this study, 1 285 cases of 13 RCTs, were included, 659 cases in Shenling Atractylodes powder group and 598 cases in western medicine group. Compared with western medicine alone, Shenling Atractylodes Powder has higher clinical efficacy (RR=1.17,95%CI [1.131.22, P0.001]). It can significantly shorten the time of improvement of diarrhea, abdominal pain, purulent blood and fever symptoms. The combined effects were (RR=-12.32,95%CI [-14.27 -10.37], P0.001), (RR=-8.06,95%CI [-9.88 -6.24], P0.001), (RR=-9.89,95%CI [-10.77], respectively. -9.00, P0.001), (RR=-8.29,95%CI [-9.59 渭 -6.98], P0.001), reducing the incidence of adverse reaction events (RR=0.06,95%CI [0.01 + 0.40], P0. 004). There was no significant difference in the therapeutic effect of Shenling Atractylodes Powder on UC under colonoscopy. Compared with western medicine alone, Shenling Atractylodes Powder has better efficacy and safety in the treatment of ulcerative colitis, and is suitable for clinical popularization. High-quality double-blind randomized controlled trials with large samples are needed.
【作者单位】：广州中医药大学第二临床医学院;广州中医药大学基础医学院;广州中医药大学第一临床医学院;
【基金】：国家自然科学基金项目(81403296) 广州中医药大学“青年英才”项目(QNYC20140101);广州中医药大学“薪火计划”基金项目(XH20140105)
【分类号】：R574.62

【相似文献】