黄芩汤加减治疗溃疡性结肠炎作用的Meta分析

Meta Analysis for the Effect of Modified Huangqin Decoction in Treatment of Ulcerative Colitis

摘要: 目的：通过Meta分析的方法比较黄芩汤、黄芩汤加减或黄芩汤、黄芩汤加减联合西药对比单纯使用西药治疗溃疡性结肠炎的疗效和安全性。方法：利用中国知网(CNKI)、维普(VIP)、中国生物医学数据库(CBMdisc)、万方数据库(WanFang Data)、PubMed、Cochrane Library、Web of Science、Embase数据库，查找以黄芩汤、黄芩汤加减或黄芩汤、黄芩汤加减联合西药为主要干预手段治疗溃疡性结肠炎的随机对照试验，检索完成后，进行文献筛选和数据提取，通过Cochrane系统评价手册对纳入的文献进行质量评价，使用Review Manager5.3软件进行Meta分析。结果：共纳入了15个研究，共计1139例患者，纳入的文献均为中低质量。Meta分析结果显示，黄芩汤、黄芩汤加减或黄芩汤、黄芩汤加减联合西药治疗溃疡性结肠炎在总有效率上[RR = 1.25, 95%CI (1.12, 1.39), Z = 4.06, P < 0.0001]明显优于单用西药。与单用西药相比，黄芩汤、黄芩汤加减或黄芩汤、黄芩汤加减联合西药能显著降低总体临床症状积分[MD = −2.16, 95%CI (−2.62, −1.70), Z = 9.24, P < 0.00001]。同时，黄芩汤、黄芩汤加减或黄芩汤、黄芩汤加减联合西药能明显降低不良反应发生率[RR = 0.12, 95%CI (0.05, 0.29), Z = 4.77, P < 0.00001]。结论：黄芩汤、黄芩汤加减或黄芩汤、黄芩汤加减联合西药治疗溃疡性结肠炎较单用西药能提高临床疗效和安全性，能够有效降低临床症状积分，对临床用药具备一定指导价值。

Abstract: Objective: To compare the efficacy and safety between modified Huangqin decoction or Huangqin decoction combination with western medicine to single western medicine for treatment of ulcerative colitis by Meta analysis. Methods: CNKI, VIP, CBM, Wanfang Data, PubMed, Cochrane Library and Web of Science and EMBASE were used to check the randomized controlled trials for treatment of ulcerative colitis of Huangqin decoction or Huangqin decoction with western medicine. The papers were screened and extracted. The extracted data were evaluated with Cochrane system evaluation manual and performed Meta-analysis with Review Manager 5.3 Software. Results: The result of 15 studies involving 1139 patients was included and the included papers were of medium and low quality. The results of Meta-analysis showed that the total effective rate of modified Huangqin decoction or Huangqin decoction combination with western medicine in the treatment of ulcerative colitis [RR = 1.25, 95%CI (1.12, 1.39), Z = 4.06, P < 0.0001] was significantly better than that of western medicine alone. Compared with western medicine alone, the total clinical symptom score significantly reduces [MD = −2.16, 95%CI (−2.62, −1.70), Z = 9.24, P < 0.00001] by Huangqin decoction or Huangqin decoction combination with western medicine. While, the incidence of adverse reactions [RR = 0.12, 95%CI (0.05, 0.29), Z = 4.77, P < 0.00001] also markedly lowered by Huangqin decoction or Huangqin decoction combination with western medicine, as compared with western medicine alone. Conclusion: Huangqin decoction or Huangqin decoction combination with western medicine can raise the clinical efficacy and safety in treatment of ulcerative colitis, effectively reduce the clinical symptom score, which provided a guiding value for clinical medication.