中成药治疗消化性溃疡的系统评价再评价
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国家重点研发计划“中医药现代化研究”项目(2022YFC3500701)——腧穴效应规律及配伍机制项目;中医药循证能力建设项目(2019XZZX-XH011);陕西省第三届名中医传承工作室建设项目(2019021)


Overview of Systematic Reviews of Chinese Patent Medicine in the Treatment of Peptic Ulcer
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    摘要:

    目的:对中成药治疗消化性溃疡(PU)的系统评价进行再评价。方法:检索PubMed、Cochrane Library、Embase、国家知识基础设施数据库(CNKI)、中国生物医学文献数据库(CBM)、中国学术期刊数据库(CSPD)及中文科技期刊数据库(CCD),2名研究者独立筛选文献、提取资料,纳入中成药治疗PU的系统评价,采用多项系统综述评价2(AMSTAR 2)、系统评述和Meta分析优先报告条目(PRISMA)评价纳入系统评价的方法学质量和报告质量,应用建议评价开发和评估分级(GRADE)量表评价纳入系统评价的方法学质量、报告质量和证据质量。结果:共纳入系统评价10个,AMSTAR 2评价结果,系统评价为高质量1个,中质量5个,低质量3个,极低质量1个。PRISMA评价结果,系统评价报告相对完整6个,存在一定缺陷3个,存在相对严重缺陷1个。纳入系统评价10个报告了结局指标42个,GRADE评价结果,高质量6个,中质量27个,低质量8个,极低质量1个。与常规西药治疗比较,康复新液可提高临床有效率及溃疡愈合率,联合常规西药可提高内镜下总有效率、临床有效率和溃疡愈合率,降低临床症状改善积分和溃疡复发率;复方丹参滴丸联合常规西药可提高临床疗效;胃复春联用常规西药的临床疗效和Hp根除率更高,胃泌素水平更低;健胃愈疡片的总有效率、治愈率更高;荆花胃康胶丸联合常规西药可改善总有效率、溃疡愈合率和Hp根除率。结论:中成药或其联合常规西药治疗PU疗效优于常规西药治疗,但由于纳入系统评价的方法学质量、报告质量及证据质量存在一定缺陷,应慎重对待。

    Abstract:

    To overview the systematic reviews of Chinese patent medicine in the treatment of peptic ulcer(PU).Methods:PubMed,Cochrane Library,Embase,China National Knowledge Infrastructure(CNKI),China Biology Medicine(CBM),China Science Periodical Database(CSPD),and Chinese Citation Database(CCD) databases were searched.Two reviewers independently screened the literature,extracted data,and included a systematic review of Chinese patent medicine in the treatment of PU.Then,AMSTAR 2,systematic reviews,and PRISMA were used to evaluate the methodological quality and report quality of the included systematic reviews.GRADE was employed to assess the methodological quality,report quality,and evidence quality of the included systematic reviews.Results:A total of 10 systematic reviews were included.The evaluation results of the AMSTAR 2 showed that one article was of high quality; five articles were of moderate quality; three articles were of low quality,and one article was of extremely low quality.PRISMA evaluation results showed that six reports of systematic reviews were relatively complete; three reports of systematic reviews had certain defects,and one report of systematic review had relatively serious defects.The included ten systematic reviews reported 42 outcome indicators.GRADE evaluation results showed that six outcome indicators were of high quality; 27 outcome indicators were of medium quality; eight outcome indicators were of low quality,and one outcome indicator was of extremely low quality.Compared with conventional western medicine treatment,Kangfuxin Liquid could improve the clinical effective rate and ulcer healing rate,while combined with conventional western medicine,it could improve the total effective rate under endoscopy,clinical effective rate,and ulcer healing rate and reduce the clinical symptom improvement scores and ulcer recurrence rate; compound Danshen Dripping Pills combined with conventional western medicine could improve clinical efficacy; Weifuchun combined with conventional western medicine had higher clinical efficacy and Hp eradication rate and lower gastrin level; Jianweiyuyang Tablets had higher total effective rate and cure rate; Jinghua Weikang Capsules combined with conventional western medicine could improve the total effective rate,ulcer healing rate,and HP eradication rate.Conclusion:The efficacy of the above-mentioned Chinese patent medicine or their combination with conventional western medicine in the treatment of PU is better than that of conventional western medicine,but the methodological quality,report quality,and evidence quality of the included systematic reviews have some defects,so it should be treated with caution.

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雷玉玉,杨清瑞,杜晓泉,李昕株.中成药治疗消化性溃疡的系统评价再评价[J].世界中医药,2024,(04).

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  • 收稿日期:2022-07-06
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  • 在线发布日期: 2024-05-15
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