摘要
目的:本研究旨在通过Meta分析方法,系统评估经典名方一贯煎在干燥综合征、慢性胃炎、肝纤维化与肝硬化等临床疾病中的治疗效果。方法:全面检索知网(CNKI)、万方(Wanfang Data)、维普(VIP)、中国生物医学文献服务系统(SinoMed)、Web of Science与PubMed共6个数据库,检索时间为各平台建库至2024年2月18日。纳入一贯煎干预干燥综合征、慢性胃炎、肝纤维化与肝硬化的临床研究,对各病种纳入的结局指标进行数据提取和Meta分析。同时,采用Egger检验评估潜在的发表偏倚,并通过逐一剔除法进行敏感性分析。结果:共纳入26项研究,其中干燥综合征12项研究,病例898例;慢性萎缩性胃炎2项研究,病例159例;肝纤维化与肝硬化14项研究,病例1018例。Meta分析结果表明,一贯煎对干燥综合征的泪液分泌[SMD=1.08,95%CI(0.30,1.85),P=0.0158]及其他血清学指标有改善作用;能降低慢性萎缩性胃炎的内镜评分[MD=-1.66,95%CI(-2.22,-1.10),P<0.0001];降低肝纤维化血清学指标Ⅲ型前胶原[MD=-40.34,95%CI(-71.40,-9.29),P=0.0191]与层黏连蛋白[MD=-53.12,95%CI(-87.14,-19.09),P=0.0088]水平以及肝硬度[MD=-2.61,95%CI(-2.80,-2.41),P=0.0003]。结论:一贯煎临床用于干燥综合征、慢性萎缩性胃炎与肝纤维化具有较好的临床效果。当前研究对于其安全性评价尚不充分,仍然需要进一步的验证。
Objective:To explore the clinical applications of classic prescription Yiguanjian decoction based on Meta analyses.Methods:Six databases,including CNKI,Wanfang Data,VIP,Sinomed,Web of Science,and PubMed were screened from inception to Feb 18 th,2024.Clinical trials about Yiguanjian decoction for the treatment of Sj gren syndrome,chronic gastritis,liver fibrosis,and cirrhosis were included,then relevant outcomes of these trials were pooled in Meta analyses.Egger test was applied to assess publication bias,and leave-one-out method was utilized for sensitivity analysis.Results:Twenty-six studies,involving 12 studies for Sj gren syndrome with 898 participants,2 studies for chronic gastritis with 159 participants,and 14 studies for liver fibrosis and cirrhosis with 1018 participants,were included.Meta analyses indicated that for Sj gren syndrome,the result of Schirmer test(SMD=1.08,95%CI[0.30,1.85],P=0.0158)and other serologic metrics were improved;for chronic gastritis,endoscopic assessment(MD=-1.66,95%CI[-2.22,-1.10],P<0.0001)was relieved,for liver fibrosis,serologic type III procollagen peptide(MD=-40.34,95%CI[-71.40,-9.29],P=0.0191)and laminin(MD=-53.12,95%CI[-87.14,-19.09],P=0.0088)were reduced.Moreover,liver stiffness was also relieved(MD=-2.61,95%CI[-2.80,-2.41],P=0.0003).Conclusion:Yiguanjian decoction is clinically applied for Sj gren syndrome,chronic gastritis,liver fibrosis,and cirrhosis with considerable therapeutic effect.However,safety assessment was insufficient,while further validation and pharmacovigilance are still required.
作者
张晟安
张炜捷
周文君
贾永娟
张莉
季光
ZHANG Sheng-an′;ZHANG Wei-jie;ZHOU Wen-jun;JI Guang(Institute of Digestive Disease,Longhua Hospital,Shanghai University of Traditional Chinese Medicine(Shanghai,200032),China)
出处
《中西医结合肝病杂志》
CAS
2024年第11期1008-1016,共9页
Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases
基金
上海市卫生健康委员会中医药传承创新发展三年行动计划[No.ZY(2021-2023)-0211]。
关键词
一贯煎
干燥综合征
慢性萎缩性胃炎
肝纤维化
META分析
循证医学
yiguanjian decoction
classic prescription
sj gren′s syndrome
chronic atrophic gastritis
liver fibrosis
meta-analysis
evidence-based medicine
