目的 通过AMSTAR-2及GRADE对中医治疗胃食管反流病的Meta分析文献进行质量评价及分级,以期为临床医师使用中医治疗胃食管反流病提供参考.方法 系统检索中国知网、万方-中国学术期刊数据库、中文科技期刊数据库(维普)、中国生物医学文献数据库、PubMed、EMbase、Web of Science,建立纳入及排除标准,筛选采用中医治疗胃食管反流病的Meta分析文献,使用AMSTAR-2及GRADE进行方法学质量评价及证据分级.结果 最终纳入18篇文献,对于反流性食管炎和胃食管反流病,单纯采用中医药或者联合西药其疗效均优于单纯采用西药治疗,且复发率均低于西药组.但通过AMSTAR-2质量评价发现仅1篇文献可信度为中,1篇文献可信度为低,其余16篇文献可信度为极低.GRADE分级发现有效率、胃镜下有效率、复发率、不良反应率评级为低级或极低级,主要原因是研究局限性大.结论 中医治疗胃食管反流病具有一定优势,但方法学质量及证据分级较低,需谨慎看待本研究结果,未来临床医师需不断提高临床研究质量,提高中医临床循证证据.
Meta-analysis Re-evaluation of the Efficacy of Traditional Chinese Medicine in the Treatment of Gastroesophageal Reflux Disease Based on AMSTAR-2 Quality Evaluation and GRADE Classification
Objective To evaluate and grade the quality of Meta-analysis literature of traditional Chinese medicine in the treatment of gastroesophageal reflux disease by AMSTAR-2 and GRADE,so as to provide reference for clinicians to use traditional Chinese medicine in the treatment of gastroesophageal reflux disease.Methods CNKI,Wanfang-China Academic Journal Database,Chinese Science and Technology Journal Database(VIP),Chinese Biomedical Literature Database,PubMed,Embase,and Web of Science were systematically searched to establish inclusion and exclusion criteria.Meta-analysis literature on the treatment of gastroesophageal reflux disease with traditional Chinese medicine was screened,and AMSTAR-2 and GRADE were used for methodological quality evaluation and evidence grading.Results Finally,18 articles were included.For reflux esophagitis and gastroesophageal reflux disease,the efficacy of traditional Chinese medicine alone or combined with western medicine was better than that of western medicine alone,and the recurrence rate was lower than that of western medicine group.However,through the AMSTAR-2 quality evaluation,it was found that only 1 article had medium credibility,1 article had low credibility,and the remaining 16 articles had extremely low credibility.The GRADE classification found that the effective rate,the effective rate under gastroscopy,the recurrence rate,and the adverse reaction rate were rated as low or very low,mainly because of the limitations of the study.Conclusion Traditional Chinese medicine has certain advantages in the treatment of gastroesophageal reflux disease.However,the methodological quality and evidence grading of the studies in this field are relatively low.Therefore,it is necessary to be cautious when interpreting the results of this research.In the future,clinicians need to continuously improve the quality of clinical research and improve the clinical evidence-based evidence of traditional Chinese medicine.
Gastroesophageal reflux diseaseTraditional Chinese Medicine treatmentMeta-analysis re-evaluationAMSTAR-2GRADEMethodological quality assessment
国家科技期刊平台
NSTL
万方数据
