口服中成药治疗十二指肠溃疡的贝叶斯网状Meta分析

Bayesian network meta-analysis of oral Chinese patent medicine in the treatment of duodenal ulcer

关键词:  中成药  十二指肠溃疡  网状Meta分析  随机对照试验  贝叶斯模型

Key words:  proprietary Chinese medicine  Duodenal ulcer  Mesh meta-analysis  Randomized controlled trials  Bayesian model

摘要:

[ ]:目的 运用网状Meta分析评估服用不同中成药治疗十二指肠溃疡的疗效与安全性,为临床用药提供循证依据。方法 计算机检索VIP、Wanfang、CNKI、PubMed、CBM、Cochrane Library、Web of Science等数据库,搜索公开发表中成药治疗十二指肠溃疡的随机对照试验(randomized controlled trial,RCT),检索时限至2023年11月。采用Cochrane5.4手册对纳入的RCT进行质量评价。运用ADDIS软件进行贝叶斯网状Meta数据结果比较及排序。结果 最终纳入23篇RCT,总样本量2967例,共纳入11种口服中成药。网状Meta分析结果表明,有效率前三排序:胃复春片＋化学药＞胃苏颗粒＋化学药＞致康胶囊＋化学药Hp转阴前三排序:荆花胃康胶囊(胶丸)＋化学药＞龙七胃康片+化学药＞蒲元和胃胶囊＋化学药缓解反酸症状前三排序:荜玲胃痛冲剂＞蒲元和胃胶囊＞荆花胃康胶囊(胶丸)＋化学药,缓解胃胀症状前三排序:蒲元和胃胶囊＞荆花胃康胶囊(胶丸)＋化学药＞荜玲胃痛冲剂,腹痛时间情况前三排序:荆花胃康胶囊(胶丸)=胃苏颗粒＋化学药=致康胶囊+化学药 结论 治疗十二指肠溃疡采用口服中成药的方案中,提高有效率方面优选胃复春片联合化学药,针对改善相关临床症状方面,首选荆花胃康胶囊(胶丸)联合化学药对Hp转阴最有效,荜玲胃痛冲剂缓解反酸症状最有效,蒲元和胃胶囊缓解胃胀症状最有效,荆花胃康胶囊(胶丸)、胃苏颗粒合用化学药、致康胶囊合用化学药减少腹痛时间最有效,临床中可根据患者的具体情况合理准确选择用药。

Abstract:

ABSTRACT:OBJECTIVE To evaluate the efficacy and safety of different Chinese patent medicines in the treatment of duodenal ulcer by network Meta-analysis, so as to provide evidence-based basis for clinical medication. METHOD We searched VIP, Wanfang, CNKI, PubMed, CBM, Cochrane Library, Web of Science and other databases. The published randomized controlled trials (RCTS) of Chinese patent medicine in the treatment of duodenal ulcer were searched, and the retrieval time was limited to November 2023. Cochrane5.4 manual was used to evaluate the quality of the included RCTS. ADDIS software was used to compare and rank the results of Bayesian network Meta-analysis. RESULT Twenty-three RCTS were included, with a total sample size of 2967 cases, and a total of 11 kinds of oral Chinese patent drugs were included. The results of network Meta-analysis showed that the top three effective rates were Weifuchun tablets + chemical drugs > Weishu granules + chemical drugs > Zhikang capsules + chemical drugs. The top three effective rates were Jinghua Weikang capsules (soft capsules) + chemical drugs > Longqi weikang tablets + chemical drugs > Puyuanhewei capsules + chemical drugs for relieving acid reflux symptoms. The top three order of relieving symptoms of stomach distension: Puyuanhewei capsule > Jinghuaweikang capsule + chemical medicine > Puyuanhewei capsule > Jinghuaweikang capsule + chemical medicine > Pib Weikang granule, the top three order of abdominal pain time: Jinghua Weikang capsule (soft pill) = Weishu granule + chemical medicine = Zhikang capsule + chemical medicine. CONCLUSION Weifuchun tablet combined with chemical medicine is the best choice for the treatment of duodenal ulcer. Jinghua Weikang capsule (soft pill) combined with chemical medicine is the best choice for the improvement of related clinical symptoms. Cub Ling Weitong granule is the most effective in relieving acid reflux symptoms, Puyuan Hewei capsule is the most effective in relieving stomach distension symptoms, Jinghua Weikang capsule (soft pill), Weisu granule combined with chemical drugs, Zhikang capsule combined with chemical drugs are the most effective in reducing abdominal pain time. In clinical practice, drugs can be selected reasonably and accurately according to the specific conditions of patients.