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中国医药导刊 ›› 2023, Vol. 25 ›› Issue (5): 482-490.

• 中医中药 • 上一篇    下一篇

半夏泻心汤治疗功能性消化不良有效性和安全性的Meta分析

 顾任钧1a, 邹得方1b, 陶睿智1b, 陆可沁1b, 任浪1a, 孙志广2*   

  1. 1.南京中医药大学 中医学院·中西医结合学院a,药学院\江苏省中药药效与安全性     评价重点实验室b, 江苏 南京 210023;  2.江苏省第二中医院消化科, 江苏 南京 210023
  • 收稿日期:2023-02-23 修回日期:2023-03-24 出版日期:2023-05-28 发布日期:2023-05-28
  • 基金资助:
    国家自然科学基金项目(项目编号:82074312;项目名称:基于5-HTR/TAS2Rs探讨半夏泻心汤辛开/苦降协同作用的分子机制);江苏省中医药科技发展计划青年人才项目(项目编号:QN202206; 项目名称:基于5-HT4R/TAS2R38研究半夏泻心汤辛开苦降法治疗胃食管反流病增效机制)

The Efficacy and Safety of Banxia Xiexin Decoction in Treating Functional Dyspepsia: A Meta-Analysis

  1. 1.School of Chinese Medicine and School of Integrated Chinese and Western Medicinea, Jiangsu Key Laboratory for Pharmacology and Safety Evaluation of Chinese Materia Medica, School of Pharmacyb, Nanjing University of Chinese Medicine, Jiangsu Nanjing 210023, China;  2.Digestive Department of Jiangsu Second Chinese Medicine Hospital, Jiangsu Nanjing 210023, China
  • Received:2023-02-23 Revised:2023-03-24 Online:2023-05-28 Published:2023-05-28

摘要: 目的:系统评价《伤寒论》经方半夏泻心汤治疗功能性消化不良的疗效及其安全性。方法:计算机检索Cochrane Library、PubMed、Web of Science、Embase、万方数据库、中国知网、维普数据库和中国生物医学文献数据库。检索对象为从建库到2022年2月1日收录的所有半夏泻心汤治疗功能性消化不良临床随机对照试验相关文献并对所纳入文献的质量进行评价。采用RevMan 5.3进行Meta分析。结果:Meta分析结果显示,半夏泻心汤治疗FD有效率RR=1.25,95% CI [1.19,1.32];半夏泻心汤降低FD患者综合症状评分WMD=-1.90,95% CI [-2.53,-1.28];缓解腹痛WMD=-1.45,95% CI [-2.20,-0.69];缓解腹胀WMD=-0.79,95% CI [-1.01,-0.57];缓解嗳气WMD=-0.42,95% CI [-0.67,-0.16];缓解反酸WMD=-0.40,95% CI [-0.75,-0.04];降低胃半排空时间:MD=-10.19,95% CI [-14.79,-5.59];降低胃全排空时间:MD=-25.00,95% CI [-29.31,-20.69];提升胃蠕动幅度(短直径):MD=0.25,95% CI [0.16,0.34];提升胃蠕动幅度(长直径):MD=0.97,95% CI [0.89,1.05];提升胃蠕动频率:MD=1.07,95% CI [0.29,1.85];减少胃肥大细胞个数:MD=-5.15,95% CI [-7.69,-2.61];增加胆囊收缩素分泌:MD=18.25,95% CI [10.61,25.89];增加胃动素分泌MD=39.01,95% CI [30.35,47.66]。所纳入的文献中没有报道使用半夏泻心汤后发生不良反应。结论:研究发现半夏泻心汤可以有效治疗功能性消化不良,改善腹痛、腹胀、嗳气等相关症状、增加胃肠动力和胃肠激素分泌,且使用半夏泻心汤治疗无明显不良反应。为临床治疗功能性消化不良提供新的思路,未来需要更多高质量的试验加以验证。

关键词: font-size:medium, ">半夏泻心汤;功能性消化不良;随机对照试验;系统评价;Meta分析

Abstract: Objective: To systematically evaluate the efficacy and safety of the treatment of functional dyspepsia with Banxia Xiexin decoction (a classical formula of “Treatise on Febrile Diseases”). Methods: The Cochrane Library, PubMed, Web of Science, Embase, Wanfang database, CNKI, VIP database and CBMdisc were searched. All clinical randomized controlled trials on the treatment of functional dyspepsia with Banxia Xiexin decoction from the date of establishment of the database to February 1, 2022 were searched and the quality of the included literature was evaluated. Meta-analysis was performed using RevMan 5.3. Results: The results of Meta-analysis showed that the efficiency of Banxia Xiexin decoction in the treatment of FD: RR=1.25, 95% CI [1.19, 1.32]; Banxia Xiexin decoction decreasing the composite symptom score of FD patients: WMD=-1.90, 95% CI [-2.53, -1.28]; relieving abdominal pain: WMD=-1.45, 95% CI [-2.20, -0.69]; relieving abdominal distention: WMD=-0.79, 95% CI [- 1.01, -0.57]; relieving belching: WMD=-0.42, 95% CI [-0.67, -0.16]; relieving acid reflux: WMD=-0.40, 95% CI [-0.75, -0.04]; reducing gastric half emptying time: MD=-10.19, 95% CI [-14.79, -5.59]; reducing gastric total emptying time: MD=-25.00,. 95% CI [-29.31, -20.69]; increasing gastric peristaltic amplitude (short diameter): MD=0.25, 95% CI [0.16, 0.34]; increasing gastric peristaltic amplitude (long diameter): MD=0.97, 95% CI [0.89, 1.05]; increasing gastric peristaltic frequency: MD=1.07, 95% CI [0.29, 1.85]; reducing gastric mast cells number: MD=-5.15, 95% CI [-7.69, -2.61]; increasing cholecystokinin secretion: MD=18.25, 95% CI [10.61, 25.89]; increasing the secretion of motilin: MD=39.01, 95% CI [30.35, 47.66]. Conclusion: It was found that Banxia Xiexin decoction can effectively treat functional dyspepsia and relieve abdominal pain, abdominal distension, belching and other related symptoms, increase gastrointestinal motility and gastrointestinal hormone secretion, and there was no obvious adverse reaction in the treatment. It provides evidences for the clinical treatment of functional dyspepsia, which needs to be verified by more high-quality experiments in the future.

Key words: font-size:medium, ">Banxia Xiexin decoction; Functional dyspepsia; Randomized controlled trial; Systematic review; Meta-analysis

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