基于meta分析的益气活血法治疗慢性萎缩性胃炎的系统评价

发布时间：2018-05-01 16:35

本文选题：活血益气 + 慢性萎缩性胃炎　；参考：《山东中医药大学》2016年硕士论文

【摘要】：目的:运用系统评价方法对益气活血法治疗慢性萎缩性胃炎的临床疗效进行客观评价,提供相应临床证据,促使临床医疗决策更加科学化。方法:全面收集1996年1月至2016年1月间发表在国内外各杂志报刊的相应文献,选择符合纳入标准且以中医或中西医结合疗法治疗CAG并设有相应西医对照组的临床研究;制定相关标准以筛选合格研究;采用Jadad评分标准评价文献质量,并对效应指标进行异质性检验、Meta-分析等。结果:此项研究纳入文献34篇进行系统分析,共计患者3605例;纳入研究方法学质量评价较低,其中Jadad评分3分及以下的33篇,4-7分1篇;Meta分析结果为:中医益气活血法治疗慢性萎缩性胃炎在提高综合疗效、改善胃镜和病理变化、提高HP转化率、降低复发率等方面与西医治疗相比,优势明显;统计试验组内中药使用频率,以益气活血类为主;对纳入文献行偏倚性检查,未呈“倒漏斗图”分布,其图形中各散点分布不对称,表明可能存在一定偏倚。结论:Meta-分析结果表明,运用中医学理论为指导,通过中医学思维来辨证论治,同时结合临床实际,中医益气活血法治疗慢性萎缩性胃炎疗效显著,复发率亦比较低。然而由于纳入文献方法学质量评价指标单一、研究样本量不够大、文献库偏倚或发表偏倚存在等原因,本研究存在一定局限性实属难免。
[Abstract]:Objective: to evaluate the clinical efficacy of Yiqi Huoxue method in the treatment of chronic atrophic gastritis by means of systematic evaluation, to provide the corresponding clinical evidence and to make the clinical medical decision more scientific. Methods: from January 1996 to January 2016, we collected the relevant literature published in various magazines and newspapers at home and abroad, and selected the clinical research that met the inclusion standard and treated CAG with traditional Chinese medicine or combination of traditional Chinese medicine and western medicine and had corresponding western medicine control group. Relevant criteria were established to screen qualified research, and Jadad scoring criteria were used to evaluate the quality of literature, and to test the heterogeneity of effect indicators by Meta-analysis. Results: a total of 3605 patients were included in 34 articles of the study, and the quality evaluation of the methodology was low. The results of meta-analysis showed that the treatment of chronic atrophic gastritis with the method of invigorating qi and activating blood circulation in traditional Chinese medicine could improve the comprehensive curative effect, improve the gastroscope and pathological changes, and increase the conversion rate of HP. Compared with the western medicine treatment, the advantages of reducing the recurrence rate were obvious; in the statistical test group, the use frequency of traditional Chinese medicine was mainly the type of invigorating qi and promoting blood circulation, and the bias of the literature was not "inverted funnel graph" distribution. The distribution of scattered points in the graph is asymmetric, indicating that there may be a certain bias. Conclusion the results of the analysis show that the Chinese medicine theory is used to treat chronic atrophic gastritis with TCM theory as the guide, and the TCM thinking is used to treat the patients with chronic atrophic gastritis by combining with the clinical practice, and the curative effect of traditional Chinese medicine on chronic atrophic gastritis is remarkable, and the recurrence rate is also relatively low. However, due to the single quality evaluation index of literature methodology, the lack of sample size, and the existence of library bias or publication bias, it is inevitable that this study has some limitations.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

【参考文献】