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    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

      摘要
    • 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，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:
      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.
      METHODS 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 included, 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.
      RESULTS Ultimately, 23 RCTs were included, with a total sample size of 2 967 cases. Eleven oral Chinese patent medicines were analyzed. Network meta-analysis results showed: top 3 for response rate: Weifuchun tablets + chemical drugs > Weisu granules + chemical drugs > Zhikang capsules + chemical drugs; top 3 for Hp seroconversion: Jinghua Weikang capsules(softgels) + chemical drugs > Longqi Weikang tablets + chemical drugs > Puyuan Hewei capsules + chemical drugs; top 3 for acid reflux relief: Biling Weitong granules > Puyuan Hewei capsules > Jinghua Weikang capsules(Softgels) + chemical drugs; top 3 for gastric distension relief: Puyuan Hewei capsules > Jinghua Weikang capsules(Softgels) + chemical drugs > Biling Weitong granules; top 3 for abdominal pain duration: Jinghua Weikang capsules(Softgels) = Weisu granules + chemical drugs = Zhikang capsules + chemical drugs.
      CONCLUSION In the treatment of duodenal ulcer using oral Chinese patent medicine regimens: Weifuchun tablets combined with chemical drugs is preferred to improve effective rate. For improving related clinical symptoms: Jinghua Weikang capsules(Softgels) combined with chemical drugs is most effective for Hp seroconversion; Biling Weitong granules are most effective in relieving acid reflux symptoms; Puyuan Hewei capsules is most effective in relieving gastric distension symptoms; Jinghua Weikang capsules(Softgels) combined with chemical drugs, Weisu granules combined with chemical drugs, and Zhikang capsules combined with chemical drugs are most effective in reduction of abdominal pain duration. Clinicians can reasonably and accurately select medication based on the patient's specific condition.

       

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