[1]于靖文,刘震,王少丽,等.中药联合四联疗法治疗幽门螺旋杆菌相关慢性萎缩性胃炎的系统评价[J].西部中医药,2025,38(02):51-58.[doi:10.12174/j.issn.2096-9600.2025.02.14]
　YU Jingwen,LIU Zhen,WANG Shaoli,et al.Systematic Evaluation of Chinese Medicine Combined with Quadruple Therapy in the Treatment of Hp-Related Chronic Atrophic Gastritis[J].Western Journal of Traditional Chinese Medicine,2025,38(02):51-58.[doi:10.12174/j.issn.2096-9600.2025.02.14]
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中药联合四联疗法治疗幽门螺旋杆菌相关慢性萎缩性胃炎的系统评价()
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《西部中医药》[ISSN:2096-9600/CN:62-1204/R]

卷:
38
期数:
2025年02期
页码:
51-58
栏目:
二次研究
出版日期:
2025-02-15

文章信息/Info

Title:
Systematic Evaluation of Chinese Medicine Combined with Quadruple Therapy in the Treatment of Hp-Related Chronic Atrophic Gastritis
作者:
于靖文1, 刘震1, 王少丽1, 丁媛1,2, 周铃1,2, 夏晨曦1, 李萌1, 秦珂馨1,2
1.中国中医科学院广安门医院，北京 100053
2.北京中医药大学研究生院，北京 100029
Author(s):
YU Jingwen1, LIU Zhen1, WANG Shaoli1, DING Yuan1,2, ZHOU Ling1,2, XIA Chenxi1, LI Meng1, QIN Kexin1,2
1.Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
2.Graduate School of Beijing University of Traditional Chinese Medicine, Beijing 100029, China
关键词:
萎缩性胃炎; 慢性; 幽门螺旋杆菌; 中医药; 四联疗法; 系统评价; 数据挖掘
Keywords:
atrophic gastritis;  chronic; Hp; TCM; quadruple therapy; systematic evaluation; data mining
分类号:
R256.33
DOI:
10.12174/j.issn.2096-9600.2025.02.14
文献标志码:
A
摘要:
目的系统评价中药联合四联疗法治疗幽门螺旋杆菌（helicobacter pylori，Hp）相关慢性萎缩性胃炎（chronic atrophic gastritis，CAG）的有效性，并基于循证医学方法对所纳入文献中涉及的中药处方进行数据挖掘，进而寻求治疗Hp相关CAG的用药规律。 方法检索国内外7个数据库，筛选中药联合四联疗法治疗Hp相关CAG的随机对照试验，检索时间设置为数据库建库至2021年4月1日。采用改良Jadad评分量表对文献质量进行评价；利用RevMan 5.3和Stata 15.0软件进行Meta分析，不适宜做Meta分析的结局指标采用描述性分析；应用GRADE软件对主要结局指标进行证据质量分级；应用SPSS Modeler 18.0软件进行中药处方数据挖掘。 结果最终纳入17篇符合筛选标准的文献，患者共计1564例，其中10篇文献的Jadad评分≥4分，为高质量文献；Meta分析及描述性分析结果显示，中药联合四联疗法治疗Hp相关CAG在Hp清除率（RR=1.12，95%CI：1.05～1.20，P=0.000 6）、临床总疗效（OR=3.19，95%CI：2.49～4.09，P=0.000）、中医主症候积分方面均优于常规四联疗法治疗，中药复方联合四联疗法治疗HP相关CAG在降低PGI指标程度（MD=8.24，95%CI：5.65～10.84，P＜0.000 01）、PGI/PGII指标程度（MD=0.99，95%CI：0.74～1.24，P＜0.000 01）方面优于常规四联疗法组，而在降低PGII指标程度（MD=-0.64，95%CI：-0.11～0.16，P=0.009）方面并不优于常规四联疗法组；GRADE证据质量分级显示临床总疗效及中医主症候积分为中等质量证据；数据挖掘结果显示，治疗Hp相关CAG的常用中药是白术、茯苓、党参、甘草、柴胡、丹参、黄芪、三七、白花蛇舌草。 结论中药联合四联疗法治疗Hp相关CAG具有一定治疗优势，临床治疗可以四君子汤为基础方，同时辅以活血化瘀与解毒中药增强临床疗效，但由于所纳入研究在数量及质量上具有一定局限性，因此本研究所得结论仍待临床进一步验证。
Abstract:
ObjectiveTo systematically evaluate the effectiveness of traditional Chinese medicine combined with bismuth quadruple therapy in the treatment of Hp-related chronic atrophic gastritis (CAG), and to conduct the data mining on the prescriptions of TCM involved in the included literature based on evidence-based medicine, thereby surveying the medication rules of Hp-related CAG. MethodsRandomized controlled trials (RCTs) on the treatment of Hp-related CAG with TCM and quadruple therapy were searched and screened from seven databases at home and abroad, the retrieval time ranged between the time of database establishment and April 1st, 2021. The revised Jadad scale was applied to assess the quality of the literature; RevMan 5.3 and Stata 15.0 software were utilized to perform Meta analysis, descriptive analysis was used for outcome indicators that were not suitable for Meta analysis; GRADE software was applied to grade the evidence quality for the primary outcome indicators; SPSS Modeler 18.0 software was utilized to conduct data mining on herbal prescriptions. ResultsThere were 17 papers that met the inclusion criteria, and 1564 patients, among them, ten articles with Jadad scores≥4 points were of high quality; Meta analysis and descriptive analysis results displayed that the combination of herbs and quadruple therapy were better than routine quadruple therapy in the treatment of Hp-related CAG in Hp eradication rate (RR=1.12, 95%CI:1.05～1.20, P=0.000 6), clinical efficacy of the treatment (OR=3.19, 95%CI: 2.49～4.09, P=0.000), and the scores of TCM main syndrome, When it comes to treating HP - related CAG, the combination of TCM compound and quadruple therapy outperformed the conventional quadruple therapy group in reducing the levels of the PGI index (MD = 8.24, 95% CI: 5.65～10.84, P<0.000 01) and the PGI/PGII index (MD=0.99, 95% CI: 0.74～1.24, P<0.000 01). Nevertheless, in terms of reducing the level of the PGII index (MD = - 0.64, 95% CI: - 1.11～0.16, P=0.009), it is not superior to the conventional quadruple therapy group; The grading of evidence quality of GRADE revealed that clinical efficacy of the treatment and the scores of TCM main syndrome were of medium-quality evidence; the results of data mining showed that the commonly-used drugs in the treatment of Hp-related CAG contained Baizhu (Atractylodes macrocephala Koidz.), Fuling [Poria cocos (Schw.) Wol], Dangshen (Codonopsis radix), Gancao (Glycyrrhizae radix et rhizoma), Chaihu (Bupleuri Radix), Danshen (Salviae miltiorrhizae radix et rhizoma), Huangqi (Astragali radix), Sanqi (Notoginseng radix et Rhizoma) and Baihuasheshecao (Hedyotis diffusa). ConclusionTraditional Chinese medicine combined with bismuth quadruple therapy in the treatment of Hp-related CAG owns certain therapeutic advantages, Sijunzi Tang could be adopted as the basic prescription in clinic, meanwhile the combination with the herbs of activating blood and removing blood stasis and detoxification could enhance clinical effects, however, the conclusion of the study needs to be further verified in clinic due to certain limitations existed in the quantity and quality of the included studies.

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备注/Memo

备注/Memo:
于靖文（1997—），女，硕士学位，医师。研究方向：中西医结合防治消化系统疾病的研究。首都卫生发展科研专项项目（首发2020-2-4152）；中国中医科学院广安门医院国家中医临床研究示范基地科研专项暨所级科研基金项目（2019S445）。
更新日期/Last Update: 2025-02-15