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胃复春治疗慢性萎缩性胃炎的系统评价

Weifuchun for Chronic Atrophic Gastritis:A Systematic Review

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【作者】 朱亮亮田金徽拜争刚杨克虎吴静赵锋辉马彬

【Author】 ZHU Liang-liang1,2,TIAN Jin-hui2,3,BAI Zheng-gang2,3,YANG Ke-hu2,3,WU Jing2,4,ZHAO Feng-hui1,2,MA Bin2,3, 1.School of Public Health,Lanzhou University,Lanzhou 730000,China;2.Evidence-Based Medicine Center of Lanzhou University,Lanzhou 730000,China;3.School of Basic Medicine,Lanzhou University,Lanzhou 730000,China;4.School of Clinical Medicine,Lanzhou University,Lanzhou 730000,China

【机构】 兰州大学公共卫生学院兰州大学循证医学中心兰州大学基础医学院兰州大学临床医学院

【摘要】 目的系统评价胃复春治疗慢性萎缩性胃炎(CAG)的疗效和安全性。方法计算机检索CochraneLibrary(2007年第3期)、EMbase(1974~2007.6)、PubMed(1966~2007.6)、VIP数据库(1989~2007.6)、CNKI数据库(1979~2007.6)、CBMdisc(1978~2007.6),收集胃复春治疗CAG的所有随机对照试验(RCT)和半随机对照试验(quasi-RCT),按照Cochrane系统评价手册推荐的简单评价法对纳入研究的方法学质量进行严格评价,对同质研究使用RevMan4.2.7软件进行Meta分析。结果共纳入8个研究,包括816例患者。Meta分析结果显示:与对照组相比,胃复春治疗CAG胃镜检查有效率[RCT:RR=1.54,95%CI(1.31,1.81);quasi-RCT:RR=1.52,95%CI(1.23,1.88)]、病理检查有效率[RCT:RR=1.99,95%CI(1.54,2.58)]、药物不良反应、临床总体症状缓解率[RCT:RR=1.47,95%CI(1.30,1.66);quasi-RCT:RR=1.44,95%CI(1.23,1.68)]、单个症状缓解率、伴IM/ATP疗效、HP转阴率[RR=1.26,95%CI(1.02,1.56)]、血红蛋白变化情况[WMD=16.8,95%CI(14.57,19.07)]等方面均显示出较好的疗效。结论与对照组相比,胃复春治疗CAG疗效较好,但由于临床研究质量普遍较低,且缺乏安全性研究资料,加之样本量有限,对胃复春治疗CAG的有效性和安全性尚不能得出肯定结论,有待于高质量、大样本、多中心的双盲随机对照试验结果证实。

【Abstract】 Objective To assess the effectiveness and safety of Weifuchun for chronic atrophic gastritis.Methods Trials were located through electronic searches of The Cochrane Library(Issue 3,2007),EMbase(1974 to June 2007),PubMed(1966 to June 2007),CBM(1978 to June 2007),CNKI(1994 to June 2007) and VIP(1989 to June 2007).Randomized controlled trials(RCTs) and quasi-RCTs of Weifuchun for chronic atrophic gastritis were included.A critical quality assessment and Meta-analysis were performed for the included studies.RevMan 4.2.2 was used for statistical analysis.Results A total of 8 trials involving 816 patients were included.Meta-analysis showed that compared with the control group,Weifuchun for the CAG treatment group had superiority in many aspects such as effective rate according to Gastroscopy(RR 1.54 and 95%CI 1.31 to 1.81),effective rate according to Patho-check(RR 1.99 and 95%CI 1.54 to 2.58),adverse events,remission rate based on clinical symptoms(RR 1.47 and 95%CI 1.30 to 156),remission rate based on a single symptom,curative effect with IM/ATP,HP darkening rate(RR 1.26 and 95%CI 1.02 to 1.56),situation of hemoglobin change and so on.No RCTs were found to describe the safety of Weifuchun for CAG.Conclusion Because of low quality and small samples,there is no enough evidence on Weifuchun for chronic atrophic gastritis.More large-scale multi-center randomized trials are needed to investigate the role of Weifuchun for chronic atrophic gastritis.

【基金】 兰州大学本科教学质量工程专项经费支持计划高年级本科生创新能力支持项目;兰州大学循证医学中心本科教学创新项目(2007-03)
  • 【文献出处】 中国循证医学杂志 ,Chinese Journal of Evidence-Based Medicine , 编辑部邮箱 ,2009年01期
  • 【分类号】R259
  • 【被引频次】62
  • 【下载频次】1464
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