[1]张 美,姚思梦,何 佳,等.基于AMSTAR-2质量评价和GRADE分级的中医治疗胃食管反流病疗效的Meta分析再评价[J].医学信息,2024,37(11):22-28.[doi:10.3969/j.issn.1006-1959.2024.11.004]
　ZHANG Mei,YAO Si-meng,HE Jia,et al.Meta-analysis Re-evaluation of the Efficacy of Traditional Chinese Medicine in the Treatment of Gastroesophageal Reflux Disease Based on AMSTAR-2 Quality Evaluation and GRADE Classification[J].Journal of Medical Information,2024,37(11):22-28.[doi:10.3969/j.issn.1006-1959.2024.11.004]
点击复制

基于AMSTAR-2质量评价和GRADE分级的中医治疗胃食管反流病疗效的Meta分析再评价()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
37卷
期数:
2024年11期
页码:
22-28
栏目:
医学数据科学
出版日期:
2024-06-01

文章信息/Info

Title:
Meta-analysis Re-evaluation of the Efficacy of Traditional Chinese Medicine in the Treatment of Gastroesophageal Reflux Disease Based on AMSTAR-2 Quality Evaluation and GRADE Classification
文章编号:
1006-1959（2024）11-0022-07
作者:
张 美; 姚思梦; 何 佳; 等
（1.长沙市中心医院中西医结合科，湖南 长沙 410000；2.广州中医药大学研究生院，广东 广州 510000；3.广州市海珠区瑞宝街社区卫生服务中心，广东 广州 510000）
Author(s):
ZHANG Mei; YAO Si-meng; HE Jia; et al.
(1.Department of Integrative Medicine,Changsha Central Hospital,Changsha 410000,Hunan,China;2.Graduate School of Guangzhou University of Chinese Medicine,Guangzhou 510000,Guangdong,China;3.Ruibao Street Community Health Service Center,Haizhu District,Guangzhou 510000,Guangdong,China)
关键词:
胃食管反流病; 中医治疗; Meta分析再评价; AMSTAR-2; GRADE; 方法学质量评价
Keywords:
Gastroesophageal reflux disease; Traditional Chinese Medicine treatment; Meta-analysis re-evaluation; AMSTAR-2; GRADE; Methodological quality assessment
分类号:
R259
DOI:
10.3969/j.issn.1006-1959.2024.11.004
文献标志码:
A
摘要:
目的 通过AMSTAR-2及GRADE对中医治疗胃食管反流病的Meta分析文献进行质量评价及分级，以期为临床医师使用中医治疗胃食管反流病提供参考。方法 系统检索中国知网、万方-中国学术期刊数据库、中文科技期刊数据库（维普）、中国生物医学文献数据库、PubMed、EMbase、Web of Science，建立纳入及排除标准，筛选采用中医治疗胃食管反流病的Meta分析文献，使用AMSTAR-2及GRADE进行方法学质量评价及证据分级。结果 最终纳入18篇文献，对于反流性食管炎和胃食管反流病，单纯采用中医药或者联合西药其疗效均优于单纯采用西药治疗，且复发率均低于西药组。但通过AMSTAR-2质量评价发现仅1篇文献可信度为中，1篇文献可信度为低，其余16篇文献可信度为极低。GRADE分级发现有效率、胃镜下有效率、复发率、不良反应率评级为低级或极低级，主要原因是研究局限性大。结论 中医治疗胃食管反流病具有一定优势，但方法学质量及证据分级较低，需谨慎看待本研究结果，未来临床医师需不断提高临床研究质量，提高中医临床循证证据。
Abstract:
Objective To evaluate and grade the quality of Meta-analysis literature of traditional Chinese medicine in the treatment of gastroesophageal reflux disease by AMSTAR-2 and GRADE, so as to provide reference for clinicians to use traditional Chinese medicine in the treatment of gastroesophageal reflux disease.Methods CNKI, Wanfang-China Academic Journal Database, Chinese Science and Technology Journal Database (VIP), Chinese Biomedical Literature Database, PubMed, Embase, and Web of Science were systematically searched to establish inclusion and exclusion criteria. Meta-analysis literature on the treatment of gastroesophageal reflux disease with traditional Chinese medicine was screened, and AMSTAR-2 and GRADE were used for methodological quality evaluation and evidence grading.Results Finally, 18 articles were included. For reflux esophagitis and gastroesophageal reflux disease, the efficacy of traditional Chinese medicine alone or combined with western medicine was better than that of western medicine alone, and the recurrence rate was lower than that of western medicine group. However, through the AMSTAR-2 quality evaluation, it was found that only 1 article had medium credibility, 1 article had low credibility, and the remaining 16 articles had extremely low credibility. The GRADE classification found that the effective rate, the effective rate under gastroscopy, the recurrence rate, and the adverse reaction rate were rated as low or very low, mainly because of the limitations of the study.Conclusion Traditional Chinese medicine has certain advantages in the treatment of gastroesophageal reflux disease. However, the methodological quality and evidence grading of the studies in this field are relatively low. Therefore, it is necessary to be cautious when interpreting the results of this research. In the future, clinicians need to continuously improve the quality of clinical research and improve the clinical evidence-based evidence of traditional Chinese medicine.

参考文献/References:

[1]Vakil N,van Zanten SV,Kahrilas P,et al.The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus[J].Am J Gastroenterol,2006,101(8):1900-1943.[2]Nirwan JS,Hasan SS,Babar ZU,et al.Global Prevalence and Risk Factors of Gastro-oesophageal Reflux Disease (GORD): Systematic Review with Meta-analysis[J].Sci Rep,2020,10(1):5814.[3]GBD 2017 Oesophageal Cancer Collaborators.The global, regional, and national burden of oesophageal cancer and its attributable risk factors in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017[J].Lancet Gastroenterol Hepatol,2020,5(6):582-597.[4]Delshad SD,Almario CV,Chey WD,et al.Prevalence of Gastroesophageal Reflux Disease and Proton Pump Inhibitor-Refractory Symptoms[J].Gastroenterology,2020,158(5):1250-1261.e2.[5]Katzka DA,Kahrilas PJ.Advances in the diagnosis and management of gastroesophageal reflux disease[J].BMJ,2020,371:m3786.[6]Yoon SL,Grundmann O,Smith KF,et al.Dietary Supplement and Complementary and Alternative Medicine Use Are Highly Prevalent in Patients with Gastrointestinal Disorders: Results from an Online Survey[J].J Diet Suppl,2019,16(6):635-648.[7]Talley NJ,Zand Irani M.Optimal management of severe symptomatic gastroesophageal reflux disease[J].J Intern Med,2021,289(2):162-178.[8]Shea BJ,Reeves BC,Wells G,et al.AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both[J].BMJ,2017,358:j4008.[9]Guyatt G,Oxman AD,Akl EA,et al.GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables[J].J Clin Epidemiol,2011,64(4):383-394.[10]盛松,高洪阳,黄烨,等.枳术宽中胶囊辅助治疗胃食管反流病的Meta分析和试验序贯分析[J].中国中西医结合消化杂志,2021,29(4):256-262.[11]李娟,谢胜,陈广文,等.补中升阳法治疗反流性食管炎的Meta分析[J].西部中医药,2020,33(1):69-71.[12]刘伟锋,温智稀,王振常.疏肝和胃法治疗反流性食管炎临床疗效的Meta分析[J].湖南中医杂志,2020,36(11):154-156,169.[13]郑敏,唐艳萍.柴胡疏肝散为主治疗胃食管反流病的Meta分析[J].天津中医药,2016,33(8):456-461.[14]阮琪,陈颜.小柴胡汤加减治疗反流性食管炎的Meta分析[J].中国民族民间医药,2021,30(23):65-70.[15]李峰,陈淑妮,何海滨,等.乌贝散类复方治疗反流性食管炎临床疗效的Meta分析[J].现代消化及介入诊疗,2022,27(1):67-72.[16]魏堰翀,刘富林,朱哲琴,等.气滞胃痛颗粒联合质子泵抑制剂治疗反流性食管炎的Meta分析[J].广西中医药大学学报,2022,25(1):77-82.[17]王洪双,王石红,李喆,等.左金丸加减治疗肝胃郁热型胃食管反流病的系统评价[J].云南中医学院学报,2020,43(6):18-25.[18]丁军威,李先芝,陶琳.四逆散合左金丸治疗胃食管反流病的Meta分析[J].中医药导报,2020,26(12):127-132.[19]孙成宏,陈迪,王斌.通降和胃法治疗胃食管反流病临床效果的meta分析[J].解放军医药杂志,2014,26(5):54-57.[20]李依洁,王燕丽,魏玮.辛开苦降法治疗胃食管反流病随机对照试验系统评价与Meta分析[J].世界中西医结合杂志,2015,10(11):1490-1495.[21]张迎春,何海艳,杨欣,等.PPIs联合半夏厚朴汤治疗胃食管反流病疗效与安全性Meta分析[J].西部中医药,2023,36(1):62-70.[22]肖琨珉,李可歆,陈洁,等.旋覆代赭汤加减治疗反流性食管炎的Meta分析[J].世界中西医结合杂志,2019,14(2):171-175.[23]俞赟丰,徐思琦,宁子柳,等.旋覆代赭汤加减联合PPI治疗胃食管反流病的Meta分析和试验序贯分析[J].江西中医药,2022,53(3):31-37.[24]Mu JK,Feng WY,Yu T.Meta-analysis of Xiaoxianxiong Decoction in the treatment of gastroesophageal reflux disease[J].TMR Integrative Medicine,2022,9:6.[25]李建锋,谢胜,李娟,等.指针疗法治疗胃食管反流病的Meta分析[J].辽宁中医杂志,2019,46(4):819-824.[26]宋庆增,戴文杰,陈明冰,等.针刺及针药联合对比单纯药物治疗胃食管反流病的Meta分析[J].辽宁中医杂志,2019,46(12):2495-2500.[27]宋庆增,谢胜,戴文杰,等.督脉经针刺及穴位埋线治疗胃食管反流病的Meta分析[J].中国中医基础医学杂志,2020,26(7):959-962.[28]Richter JE,Rubenstein JH.Presentation and Epidemiology of Gastroesophageal Reflux Disease[J].Gastroenterology,2018,154(2):267-276.[29]李勉力,唐旭东,李海文,等.中药复方治疗胃食管反流病作用机制探讨[J].世界中医药,2022,17(15):2112-2116.[30]李婷婷,孙千惠,王蜜源,等.基于数据挖掘的胃食管反流病证素及用药规律研究[J].上海中医药杂志,2020,54(11):14-18,59.[31]李培彩,唐艳萍.胃食管反流病中医证候、证素分布特点的文献研究[J].辽宁中医杂志,2020,47(4):86-89.

相似文献/References:

[1]张发艳.双心医学的研究进展[J].医学信息,2018,31(06):48.[doi:10.3969/j.issn.1006-1959.2018.06.016]
　ZHANG Fa-yan.Research Progress of Double Heart Medicine[J].Journal of Medical Information,2018,31(11):48.[doi:10.3969/j.issn.1006-1959.2018.06.016]
[2]宫丽萍.麻杏甘石汤加减治疗咳嗽变异性哮喘的临床价值研究[J].医学信息,2018,31(10):147.[doi:10.3969/j.issn.1006-1959.2018.10.050]
　GONG Li-ping.Clinical Value of Maxingganshi Decoction in the Treatment of Cough Variant Asthma[J].Journal of Medical Information,2018,31(11):147.[doi:10.3969/j.issn.1006-1959.2018.10.050]
[3]何丽杰.中西医治疗糖尿病肾病的临床效果分析[J].医学信息,2018,31(10):149.[doi:10.3969/j.issn.1006-1959.2018.10.051]
　HE Li-jie.Clinical Effect Analysis of Diabetic Nephropathy Treated by Chinese and Western Medicine[J].Journal of Medical Information,2018,31(11):149.[doi:10.3969/j.issn.1006-1959.2018.10.051]
[4]黄俊杰,曹立幸,陈 浩,等.基于聚类和关联规则的中医治疗月经先期用药规律探讨[J].医学信息,2018,31(23):1.[doi:10.3969/j.issn.1006-1959.2018.23.001]
　HUANG Jun-jie,CAO Li-xing,CHEN Hao,et al.Discussion of the Rule of Traditional Chinese Medicine in the Treatment of Preceeded Menorrhea Based on Clustering and Association Rules[J].Journal of Medical Information,2018,31(11):1.[doi:10.3969/j.issn.1006-1959.2018.23.001]
[5]远 颖.成人社区获得性肺炎中医药研究[J].医学信息,2018,31(23):55.[doi:10.3969/j.issn.1006-1959.2018.23.016]
　YUAN Ying.Traditional Chinese Medicine Research on Adult Community Acquired Pneumonia[J].Journal of Medical Information,2018,31(11):55.[doi:10.3969/j.issn.1006-1959.2018.23.016]
[6]施懿凌,陆 丽,罗永会.脂肪肝的中医药治疗研究进展[J].医学信息,2018,31(24):39.[doi:10.3969/j.issn.1006-1959.2018.24.011]
　SHI Yi-ling,LU Li,LUO Yong-hui.Research Progress on Traditional Chinese Medicine Treatment of Fatty Liver[J].Journal of Medical Information,2018,31(11):39.[doi:10.3969/j.issn.1006-1959.2018.24.011]
[7]汤胜男,赵党生,王凤仪,等.芍药汤治疗溃疡性结肠炎的研究[J].医学信息,2019,32(15):3.[doi:10.3969/j.issn.1006-1959.2019.15.002]
　TANG Sheng-nan,ZHAO Dang-sheng,WANG Feng-yi,et al.Study on Treating Ulcerative Colitis with Shaoyao Decoction[J].Journal of Medical Information,2019,32(11):3.[doi:10.3969/j.issn.1006-1959.2019.15.002]
[8]华启洋,吴同利,刘永艳,等.幽门螺杆菌在胃食管反流病发病中的作用[J].医学信息,2019,32(20):103.[doi:10.3969/j.issn.1006-1959.2019.20.029]
　HUA Qi-yang,WU Tong-li,LIU Yong-yan,et al.The Role of Helicobacter Pylori in the Pathogenesis of Gastroesophageal Reflux Disease[J].Journal of Medical Information,2019,32(11):103.[doi:10.3969/j.issn.1006-1959.2019.20.029]
[9]李 强.中医外治法结合微波腔内闭合术治疗 下肢静脉曲张伴溃疡的疗效[J].医学信息,2019,32(12):162.[doi:10.3969/j.issn.1006-1959.2019.12.055]
　LI Qiang.Treatment of Lower Limb Varicose Veins with Ulcer by External Treatment Combined with Microwave and Intracavitary Closure[J].Journal of Medical Information,2019,32(11):162.[doi:10.3969/j.issn.1006-1959.2019.12.055]
[10]吴鑫阳,方明治.中医药治疗恶性肿瘤相关性贫血现状[J].医学信息,2020,33(06):31.[doi:10.3969/j.issn.1006-1959.2020.06.010]
　ZHANG Zhe.Status of Treatment of Malignant Tumor-related Anemia with Traditional Chinese Medicine[J].Journal of Medical Information,2020,33(11):31.[doi:10.3969/j.issn.1006-1959.2020.06.010]

更新日期/Last Update: 1900-01-01