黄芪建中汤治疗消化性溃疡随机对照试验的Meta分析

发布时间：2018-06-10 18:52

本文选题：黄芪建中汤 + 消化性溃疡　；参考：《中国中医急症》2017年04期

【摘要】：目的评价黄芪建中汤治疗消化性溃疡的有效性。方法计算机检索中国知网(CNKI)(1979~2016)、维普网(VIP)(1989~2016)和万方数据知识服务平台(WF)(1998~2016)。将临床随机对照试验(RCTs)中所有关于黄芪建中汤与西药治疗进行对照的文献纳入,依照Cochrane Review Handbook 5.3对纳入的研究进行的质量评估由两名评价者分别独立完成。统计学分析采用软件Rev Man5.3.5进行。结果共18篇文献,2030例患者被纳入。Meta分析结果示:1)临床总有效率:黄芪建中汤配合三联疗法对照单用三联疗法,相对危险度[RR=1.11,95%CI(1.05,1.18)](P=0.0002);黄芪建中汤配合拉唑类药物对照单用拉唑类药物,相对危险度[RR=1.14,95%CI(1.06,1.22)](P=0.0005),上述差异均有统计学意义。2)临床治愈率:黄芪建中汤配合三联疗法对照三联疗法,相对危险度[RR=1.28,95%CI(1.11,1.49)](P=0.0010),差异有统计学意义。3)复发率:黄芪建中汤对照拉唑类药物,相对危险度[RR=0.33,95%CI(0.18,0.63)](P=0.0008);对照组在单用拉唑类药物基础上,根据Hp感染情况,酌情加用三联疗法,试验组在该治疗方案基础上加用黄芪建中汤,相对危险度[RR=0.09,95%CI(0.01,0.66)](P=0.02);黄芪建中汤配合三联疗法对照单用三联疗法,相对危险度[RR=0.29,95%CI(0.15,0.57)](P=0.0003)。上述差异均有统计学意义。4)Hp清除率:黄芪建中汤单用对照单用拉唑类药物疗法,相对危险度[RR=2.60,95%CI(1.73,3.91)](P0.00001);黄芪建中汤配合拉唑类药物对照单用拉唑类药物,相对危险度[RR=1.10,95%CI(1.01,1.21)](P=0.04),上述差异均有统计学意义。结论黄芪建中汤治疗消化性溃疡相比单纯使用西药治疗有一定优势,如提高临床有效率、临床治愈率、Hp清除率及降低复发率等。
[Abstract]:Objective to evaluate the efficacy of Huangqi Jianzhong decoction in the treatment of peptic ulcer. Methods to search for CNKI in China (1979) and VIPA (1989 ~ 2016) and WFN (1998 / 2016). All the literature in RCTs of clinical randomized controlled trial (RCTs) on the control of Astragalus Jianzhong decoction with western medicine treatment was included. The quality assessment of the included study according to Cochrane Review Handbook 5.3 was carried out independently by two evaluators. The statistical analysis was carried out by software Rev Man5.3.5. Results the total clinical effective rate of 2030 patients was included. Meta-analysis showed that the total effective rate was: Huangqi Jianzhong decoction combined with triple therapy, single triple therapy, relative risk [RRG1.1195CIX 1.055.1.18] Pu 0.0002N; Huangqi Jianzhong decoction combined with pyrazole drug control group was treated with single pyrazole drug, and the control group was treated with pyrazole alone, and the total effective rate was as follows: (1) the total effective rate was as follows: Huangqi Jianzhong decoction combined with triple therapy was used as control group, and the relative risk was 0.0002%. Relative risk [RRN 1.1495 CIQ 1.06C 1.22] Pao 0.0005, the above difference has statistical significance. 2) Clinical cure rate: Huangqi Jianzhong decoction combined with triple therapy control triple therapy, relative risk [RRRR1.28995 CI1.111.49] P0. 0010 (the difference is statistically significant. 3) recurrence rate: Huangqi Jianzhong decoction controls the use of pyrazole, and the relative risk (RRRN 1.28) 95CI1.111.49) P0. 0010 (P < 0. 3) recurrence rate: Huangqi Jianzhong decoction controls the use of pyrazole, and the relative risk (RRRN 1.28) 95CI1.111.49) the recurrence rate is statistically significant. Relative risk [RRX 0.33N 95] P0. 0008; in the control group, on the basis of single pyrazole drugs and according to HP infection, triple therapy was used as appropriate, and the experimental group was given Huangqi Jianzhong decoction on the basis of this treatment plan, and the control group was treated with Huangqi Jianzhong decoction, according to HP infection, and the control group was treated with Huangqi Jianzhong decoction, according to the situation of HP infection, and the control group was treated with Huangqi Jianzhong decoction. The relative risk [RRX 0.09 ~ 95 ~ 0.66] (P < 0.01); Huangqi Jianzhong decoction combined with triple therapy was treated with triple therapy alone, and the relative risk was [RRRN 0.2995 ~ 0.15 ~ (0.57)] P ~ (0.0003) ~ (3) ~ (-1) ~ (-1) ~ (-1) ~ (-1) ~ (0.66) ~ (-1) ~ (0.66) ~ (-1) ~ (-1) ~ (-1) ~ (0.66). The difference was statistically significant: Huangqi Jianzhong decoction was treated with pyrazole drugs alone, the relative risk was [RRX 2.60 ~ 95CII 1.73 ~ 3.91] P 0.00001, and Huangqi Jianzhong decoction combined with pyrazole was used as control. The relative risk (RRN 1.1095) was 1.01 / 1.21), and the difference was statistically significant. Conclusion Huangqi Jianzhong decoction has some advantages in the treatment of peptic ulcer, such as improving clinical effective rate, clinical cure rate, HP clearance rate and reducing recurrence rate.
【作者单位】：天津中医药大学;江苏省人民医院;
【基金】：国家自然科学基金资助项目(81373891)
【分类号】：R259

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