發(fā)布時間：2018-12-16 12:18

【摘要】：目的采用循證醫(yī)學(xué)的方法,系統(tǒng)評價參苓白術(shù)散聯(lián)合西藥治療潰瘍性結(jié)腸炎的臨床療效,科學(xué)了解目前的治療狀況,為今后臨床治療潰瘍性結(jié)腸炎提供科學(xué)的參考價值。方法計算機檢索中國知網(wǎng)(1982-2015)、萬方(2001-2015)、維普(1989-2015)、讀秀(1996-2015)、PUBMED(1991-2015)、PLoS公共醫(yī)學(xué)科學(xué)圖書館(1991-2015)、PMC美國國家醫(yī)學(xué)圖書館生命科學(xué)期刊(1991-2015)等數(shù)據(jù)庫,收集有關(guān)參苓白術(shù)散聯(lián)合西藥治療潰瘍性結(jié)腸炎的臨床隨機對照試驗(RCT),由2位評價者按照Cochrane系統(tǒng)評價方法,從隨機方法、盲法的運用、樣本含量、治療方法、統(tǒng)計學(xué)方法、隨訪與失訪等內(nèi)容獨立地進行文獻的篩選、資料提取與質(zhì)量評價,采用RevMan5.3統(tǒng)計軟件進行Meta分析。結(jié)果初檢出相關(guān)文獻558篇,剔除重復(fù)發(fā)表及無數(shù)據(jù)可用的文獻后獲得185篇。通過閱讀標(biāo)題和摘要及全文,最終納入10篇進入meta分析,共884例,其中治療組(口服參苓白術(shù)散聯(lián)合西藥治療)447例,對照組(口服常規(guī)西藥治療)437例。10個研究的總有效率、顯效率、無效率研究異質(zhì)性不明顯,采用固定效應(yīng)模型進行Meta分析,參苓白術(shù)散聯(lián)合西藥組在治療潰瘍性結(jié)腸炎的總有效率[OR=3.30,95%CI(2.25,4.82),P0.01]、顯效率[OR=2.02,95%CI(1.54,2.65),P0.01]均優(yōu)于對照組,有效率與對照組相近[OR=1.08,95%CI(0.78,1.50),P=0.64],無效率則低于對照組[OR=0.30,95%CI(0.21,0.44),P0.01],差異有顯著統(tǒng)計學(xué)意義;1個研究進行了復(fù)發(fā)率比較,治療組復(fù)發(fā)率19.4%;對照組復(fù)發(fā)率50.0%,兩組比較有顯著性差異(χ2=5.35,P0.05)。漏斗圖分析不對稱,表明存在發(fā)表性偏倚。結(jié)論參苓白術(shù)散聯(lián)合西藥療法治療潰瘍性結(jié)腸炎的療效與常規(guī)西藥療法相比,具有療效優(yōu)勢。受納入研究質(zhì)量與數(shù)量限制,因此上述結(jié)論仍待更多高質(zhì)量、大樣本的臨床隨機對照研究進一步驗證。
[Abstract]:Objective to evaluate the clinical effect of Shenling Atractylodes Powder combined with western medicine in the treatment of ulcerative colitis by using the method of evidence-based medicine, to scientifically understand the current treatment situation and to provide scientific reference value for clinical treatment of ulcerative colitis in the future. Methods A computer search was conducted on China Zhiwang (1982-2015), Wanfang (2001-2015), Weipu (1989-2015), PLoS (1996-2015), PUBMED (1991-2015) and), PLoS Public Medical Science Library (1991-2015). PMC National Library of Medical Sciences Journal of Life Sciences (1991-2015) and other databases collected the clinical randomized controlled trial (RCT),) related to the treatment of ulcerative colitis with Shenling Atractylodes powder combined with western medicine. Two evaluators evaluated (RCT), according to the Cochrane system. The random method, blind method, sample size, treatment method, statistical method, follow-up and lost visit were used to screen the literature, extract the data and evaluate the quality independently. The Meta analysis was carried out by RevMan5.3 statistical software. Results A total of 558 literatures were initially identified, and 185 articles were obtained after repeated publication and no data were available. By reading the title, abstract and full text, 10 articles were included in the meta analysis, including 447 cases in the treatment group (oral Shenling Baizhu Powder combined with western medicine). In the control group, 437 cases were treated by oral routine western medicine. The total effective rate, and inefficiency of 10 studies were not obvious. The fixed effect model was used for Meta analysis. The total effective rate [OR=3.30,95%CI (2.254.82), P0.01] and the effective rate [OR=2.02,95%CI (1.54 鹵2.65), P0.01] of Shenling Baizhu Powder combined with western medicine group were better than those of the control group. The effective rate was similar to that of the control group [OR=1.08,95%CI (0.78U 1.50), P < 0.64], but the ineffective rate was lower than that of the control group [OR=0.30,95%CI (0.21 鹵0.44), P0.01]. The difference was statistically significant. In one study, the recurrence rate was 19.4g in the treatment group and 50.0 in the control group. There was a significant difference between the two groups (蠂 2, 5.35, P0.05). The analysis of asymmetry by funnel graph indicates that there is a published bias. Conclusion the curative effect of Shenling Baizhu Powder combined with western medicine in the treatment of ulcerative colitis is superior to that of routine western medicine. Limited by the quality and quantity of the included studies, the above conclusions need to be further verified in a large sample of randomized controlled clinical trials with more high quality.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R574.62

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