目的 运用网状Meta分析评价康复新液、养胃舒、胃复春、香砂养胃丸、摩罗丹5种中成药辅助治疗慢性萎缩性胃炎(chronic atrophic gastritis,CAG)的临床疗效与安全性。方法 检索CNKI、VIP、Wanfang Data、CBM中文数据库及Cochrane Library、PubMed、EMbase、Web of Science外文数据库,搜索公开发表此5种中成药辅助治疗CAG的临床随机对照试验(randomized controlled trial,RCT),检索时间均为自建库至2021年3月31日,筛选出符合纳入标准的研究,按照Cochrane 5.1手册标准对纳入的研究进行文献质量评价与偏倚风险评估,采用ADDIS软件进行网状Meta数据结果比较及排序。结果 纳入51项RCTs,共计5706例患者,临床有效率方面,5种中成药辅助治疗CAG均能提高临床疗效,以康复新液临床辅助治疗效果最显著[OR=0.13, 95% CI (0.08, 0.21)];针对幽门螺杆菌(helicobacter pylori,Hp)转阴例数以胃复春辅助治疗效果显著[OR=0.24, 95% CI (0.15, 0.38)];针对胃痛、胃胀症状改善方面则优选香砂养胃丸辅助治疗[OR=0.84, 95% CI (0.72, 0.89)];针对反酸恶心、嗳气症状改善方面皆以胃复春辅助治疗显著[OR=2.96, 95% CI (0.67, 1.17);OR=0.90, 95% CI (0.08, 1.87)];针对胃黏膜萎缩病理改变方面首选摩罗丹辅助治疗[OR=0.84, 95% CI (0.72, 0.89)]。结论 5种中成药辅助治疗CAG皆具有较好的临床疗效,康复新液辅助治疗为临床首选用药,但明确的结论仍需要更多高质量RCT予以验证,临床中可根据患者的具体特征准确选择用药。

Objective To evaluate the clinical efficacy and safety of Kangfuxin Liquid (康复新液), Yangweishu (养胃舒), Weifuchun (胃复春), Xiangsha Yangwei Pills (香砂养胃丸) and Moluodan (摩罗丹) five kinds of Chinese patent medicines in the adjuvant treatment of chronic atrophic gastritis by network Meta-analysis. Methods CNKI, VIP, Wanfang Data, CBM Chinese database and Cochrane Library, PubMed, EMbase, Web of Science foreign language database were comprehensively searched, and the clinical randomized controlled trials (RCT) of the five Chinese patent medicines adjuvant therapies publicly published were searched. The retrieval time was from the self-built database until March 31, 2021. The studies that met the inclusion criteria were screened out. The included studies were evaluated for literature quality and bias risk according to Cochrane 5.1 manual standard. The net Meta data results were compared and ranked by ADDIS software. Results A total of 5706 patients were included in 51 RCTs items. In terms of clinical effective rate, five kinds of Chinese patent medicines adjuvant therapy can improve clinical efficacy, with Kangfuxin Liquid having the most significant clinical adjuvant therapy effect[OR=0.13, 95% CI (0.08, 0.21)]; For the number of helicobacter pylori (Hp) negative cases, Weifuchun was used as adjuvant therapy significantly[OR=0.24, 95% CI (0.15, 0.38)]; For the improvement of stomachache and flatulence, Xiangsha Yangwei Pills was preferred as adjuvant therapy[OR=0.84, 95% CI (0.72, 0.89)]; For the improvement of acid regurgitation nausea and belching symptoms, Weifuchun was used as adjuvant therapy significantly (OR=2.96, 95% CI (0.67, 1.17)], (OR=0.90, 95% CI (0.08,1.87)]; Morodan was the first choice for adjuvant therapy for pathological changes of gastric mucosa atrophy[OR=0.84, 95% CI (0.72, 0.89)]. Conclusion Five kinds of Chinese patent medicines have good clinical effects in the adjuvant treatment of chronic atrophic gastritis. Although the study shows that the adjuvant treatment of Kangfuxin Liquid is the first choice for improving the clinical effective rate, but the clear conclusion still needs more high-quality randomized controlled documents to be verified, and accurate selection and application can be made according to the specific characteristics of patients in clinical practice.

R285.4

山东中医药大学首批科研创新优秀团队“经方治疗重大疾病作用机理与疗效评价”（220316）；2016年度山东省重点研发计划：重点关键技术及重点产业关键技术（2016CYJS08A01-6）；山东省2017—2018年度中医药科技发展计划项目（2017-018）；山东省2015—2016年度中医药科技发展计划项目（2015-030）；山东省名老中医药专家刘昭纯传承工作室建设项目（鲁卫中发展字〔2018〕1号）；2018年度山东省高等学校科研发展计划项目（J18KB130）