浙江中医药大学学报
浙江中醫藥大學學報
절강중의약대학학보
JOURNAL OF ZHEJIANG UNIVERSITY OF TRADITIONAL CHINESE MEDICINE
2013年
7期
864-868,869
,共6页
CAG%异型增生%中医药%疗效%Meta分析
CAG%異型增生%中醫藥%療效%Meta分析
CAG%이형증생%중의약%료효%Meta분석
chronic atrophic gastritis%dysplasia%traditional Chinese medicine%cure effect%meta-analysis
[目的]分析比较中医药治疗与西医治疗慢性萎缩性胃炎(chronic atrophic gastritis，CAG)伴异型增生的疗效和安全性。[方法]检索PubMed、Cochrane图书馆、万方和中国期刊网中的随机对照试验（randomized control ed trial,RCT）文献，根据纳入标准将论文纳入研究并提取纳入研究的特征信息，按治疗方法分为西医对照组和中医药治疗组。采用RevMan5.0软件进行数据分析，先后进行异质性检验，根据检验结果选择相应的效应模型。然后进行敏感性分析，并以漏斗图、Egger回归方程评定有无发表偏倚。[结果]6篇RCT文献纳入本研究，共有632例CAG伴异型增生的患者。研究表明，中医药治疗组的临床症状、胃镜改善及病理改善情况的总显效率及总有效率的优势比（OR）均高于西医对照组；漏斗图基本呈现下宽上窄、左右对称的倒漏斗形，Egger线性回归常数项检验表明无发表偏倚。[结论]中医药治疗CAG伴异型增生能有效改善本病临床症状、胃镜及病理情况，疗效优于西医对照组。
[目的]分析比較中醫藥治療與西醫治療慢性萎縮性胃炎(chronic atrophic gastritis，CAG)伴異型增生的療效和安全性。[方法]檢索PubMed、Cochrane圖書館、萬方和中國期刊網中的隨機對照試驗（randomized control ed trial,RCT）文獻，根據納入標準將論文納入研究併提取納入研究的特徵信息，按治療方法分為西醫對照組和中醫藥治療組。採用RevMan5.0軟件進行數據分析，先後進行異質性檢驗，根據檢驗結果選擇相應的效應模型。然後進行敏感性分析，併以漏鬥圖、Egger迴歸方程評定有無髮錶偏倚。[結果]6篇RCT文獻納入本研究，共有632例CAG伴異型增生的患者。研究錶明，中醫藥治療組的臨床癥狀、胃鏡改善及病理改善情況的總顯效率及總有效率的優勢比（OR）均高于西醫對照組；漏鬥圖基本呈現下寬上窄、左右對稱的倒漏鬥形，Egger線性迴歸常數項檢驗錶明無髮錶偏倚。[結論]中醫藥治療CAG伴異型增生能有效改善本病臨床癥狀、胃鏡及病理情況，療效優于西醫對照組。
[목적]분석비교중의약치료여서의치료만성위축성위염(chronic atrophic gastritis，CAG)반이형증생적료효화안전성。[방법]검색PubMed、Cochrane도서관、만방화중국기간망중적수궤대조시험（randomized control ed trial,RCT）문헌，근거납입표준장논문납입연구병제취납입연구적특정신식，안치료방법분위서의대조조화중의약치료조。채용RevMan5.0연건진행수거분석，선후진행이질성검험，근거검험결과선택상응적효응모형。연후진행민감성분석，병이루두도、Egger회귀방정평정유무발표편의。[결과]6편RCT문헌납입본연구，공유632례CAG반이형증생적환자。연구표명，중의약치료조적림상증상、위경개선급병리개선정황적총현효솔급총유효솔적우세비（OR）균고우서의대조조；루두도기본정현하관상착、좌우대칭적도루두형，Egger선성회귀상수항검험표명무발표편의。[결론]중의약치료CAG반이형증생능유효개선본병림상증상、위경급병리정황，료효우우서의대조조。
[Objective] Through a meta-analysis to compare the effectiveness and safety of traditional Chinese medicine and western medicine in the treat-ment of chronic atrophic gastritis(CAG) with dysplasia . [Methods] Randomized clinical trials(RCTs) which compared traditional Chinese medicine and western medicine for chronic atrophic gastritis with dysplasia in PubMed, Cochrane library, WanFang and CNKI were searched. The patients which were analyzed were divided into two groups: western medicine and traditional Chinese medicine.Statistical heterogeneity between trials was evaluated by RevMan5.0. Heterogeneity of the included articles was tested and used to select proper effective model for calculation.Publication bias was investigated through visual inspection of funnel plots and Egger's regression model.[Results] 6 RCTs including 632 patients were analyzed. The total odd ratios(OR) of clinical symptoms,gastroscope symptoms,pathological symptoms by traditional Chinese medicine were higher than western medicine, the OR values were 3.40(95%CI:2.18~5.31,P<0.01),4.14(95%CI:2.37~7.20,P<0.01),2.94(95%CI:1.77~4.90,P<0.01),3.71(95%CI:2.29~6.02,P<0.01),4.41(95%CI:2.75~7.07,P<0.01),5.21 (95%CI:3.65~7.43,P<0.01). Inspection of the funnel plots for al outcome measures did not reveal evidence of publication bias( P=0.81, 0.41, 0.29, 0.88, 0.44, 0.82, respectively).[Conclusions] The treatment of chronic atrophic gastritis with dysplasia by traditional Chinese medicine can improve the excel ent response rate, overal response rate of clinical symptoms,gastroscope symptoms,pathological symptoms better than its purely western medicine treatment efficacy.
