目的:基于文献数据挖掘和Meta分析探究中药复方治疗幽门螺杆菌(Hp)相关性慢性萎缩性胃炎(CAG)的用药规律和疗效,为临床应用提供理论依据.方法:系统检索中国知网、万方数据库、中国生物医学文献数据库、Pubmed、Web of Science数据库收录的中药复方治疗Hp相关性CAG的文献,检索时间范围为各数据库自建库以来至2022年9月.首先进行数据频次统计和挖掘分析;其次进行Meta分析,采用RevMan 5.3软件对结局指标(临床疗效、Hp清除率、胃镜检查结果改善有效率、临床症状积分)进行分析.并采用GRADE证据质量分级系统对结局指标的证据质量进行评价.结果:数据挖掘部分纳入19篇文献,共涉及19个完整处方、76味中药,其中高频药物有甘草、黄芪、蒲公英、黄连、茯苓、半夏、莪术等,主要功效为益气健脾、清热祛湿、理气健胃等;药性多温、寒,药味多苦、辛,主要归脾、胃经.Meta分析纳入17篇文献,结果显示,与西药或中成药或西药联合中成药组相比,中药复方组的临床总有效率更高(P<0.05).中药复方组在清除Hp、提高胃镜检查结果改善有效率方面优于西药或西药联合中成药组(P<0.05).中药复方组在改善胃胀满、胃痛、喜热喜按、腹泻方面优于西药或中成药或西药联合中成药组(P<0.05),在改善口干口苦和纳差食少方面,中药复方组与西药或西药联合中成药组比较无统计学差异(P>0.05).GRADE评价显示证据级别为中等到极低,提示结局指标的证据质量不高.结论:Hp相关性CAG的用药以益气健脾药为主,常与具有清热除湿、疏肝和胃等功效的药物配伍使用.中药复方治疗Hp相关性CAG疗效、改善临床症状方面优于西药或中成药或两者联合治疗.但相关研究获得证据级别低,尚需开展高质量的多中心、随机对照临床试验进一步验证.
Data Mining and Meta-Analysis of Traditional Chinese Medicine Compound in the Treatment of Helicobacter pylori-Associated Chronic Atrophic Gastritis
Objective:Based on literature data mining and meta-analysis,to explore the medication rules and efficacy of traditional Chinese medicine(TCM)compound in the treatment of Helicobacter pylori(Hp)-associated chronic atrophic gastritis(CAG),so as to provide a theoretical basis for clinical application.Methods:We systematically searched the databases of CNKI,Wanfang,China Biomedical Medicine,Pubmed and Web of Science for articles about the TCM compounds in the treatment of Hp-associated CAG with the search time being the time of database establishment to September 2022.First,summary of data frequency and mining analysis were performed;Secondly,meta-analysis was performed for the outcome measures(clinical response,Hp clearance,response rate with improved gastroscopy results,clinical symptom score)using RevMan 5.3 software.The quality of evidence for outcome measures was evaluated using the Grading of Recommendations Assessment,Development,and Evaluation(GRADE)system.Results:For data mining,19 articles were included,including 19 complete prescriptions and 76 kinds of traditional Chinese medicines,among which medicines with high frequency were Glycyrrhizae Radix et Rhizoma,Astragali Radix,Taraxaci Herba,Coptidis Rhizoma,Poria,Pinelliae Rhizoma,Curcumae Rhizoma,etc.The main effects were nourishing qi and invigorating spleen,clearing away heat and expelling dampness,and regulating qi and strengthening stomach,etc.The properties were mostly warm and cold,the tastes were mostly bitter and pungent,and the meridial distribution was mainly spleen and stomach.Meta-analysis included 17 articles,and the results showed that the total response rate was higher in the TCM compound group than that in the groups of western medicine,Chinese patent medicine and western medicine combined with Chinese patent medicine(P<0.05).Compared with the groups of western medicine and western medicine combined with Chinese patent medicine,the Hp clearance and response rate with improved gastroscopy results were superior in the TCM compound group(P<0.05),and the improvements in stomach fullness,stomachache,warm food intake and liking pressing,and diarrhea were superior in the TCM compound group(P<0.05).And there was no significant difference in improving dry mouth,bitter mouth,and poor appetite between the TCM compound group and the group of western medicine or western medicine combined with Chinese patent medicine(P>0.05).The GRADE-based evaluation showed a moderate to very low level of evidence,suggesting poor quality of evidence for the outcome measures.Conclusion:Hp-associated CAG is primarily treated with medicines for nourishing qi and invigorating spleen,commonly combined with the medicines with effects of clearing away heat and expelling dampness,and soothing the liver and stomach.The TCM compound is superior to the western medicine or Chinese patent medicine or western medicine combined with Chinese patent medicine in terms of efficacy and clinical symptom improvements for Hp-associated CAG.However,the level of evidence obtained from related studies is low,thus the validation of the conclusion is required through future high-quality multi-center,randomized controlled clinical trials.
traditional Chinese medicine compoundsHelicobacter pylorichronic atrophic gastritisdata miningmeta-analysis
万方数据
维普
