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目的:系统评价参苓白术散联合氨基水杨酸制剂治疗溃疡性结肠炎的疗效,为临床提供循证参考。方法:计算机检索PubMed、Cochrane 图书馆、中国期刊全文数据库、中文科技期刊数据库、万方数据库和中国生物医学文献数据库,收集参苓白术散联合氨基水杨酸制剂(试验组)对比氨基水杨酸制剂单用(对照组)治疗溃疡性结肠炎的随机对照试验(RCT),提取资料并按照Corchane 系统评价员手册 5.1.0评价质量后,采用Rev Man 5.2统计软件进行Meta分析。结果:最终纳入14项RCT,共计1 177例患者。Meta分析结果显示,试验组患者总有效率显著高于对照组[OR=3.40,95%CI(2.44,4.74),P<0.001]、 Sutherland 疾病活动指数(DAI)评分[MD=-1.31,95%CI(-2.07,-0.56),P<0.001]、肿瘤坏死因子α[SMD=-1.90,95%CI(-2.90,-0.90),P<0.001] 、白细胞介素17(IL-17)[MD=-85.18,95%CI(-100.51,-69.85),P<0.001] 、IL-23[MD=-113.27,95%CI(-132.34,-94.21),P<0.001]水平均显著低于对照组,差异均有统计学意义。结论:参苓白术散联合氨基水杨酸制剂治疗溃疡性结肠炎疗效优于氨基水杨酸制剂单用,可以显著降低患者DAI和血清中相关细胞因子水平。
OBJECTIVE: To evaluate clinical efficacy of Shenling baizhu powder combined with aminosalicylic acid in the treatment of ulcerative colitis (UC), and to provide evidence-based reference in clinic. METHODS: Retrieved from PubMed, Cochrane library, CJFD, VIP, Wanfang database and CBM, randomized controlled trials (RCTs) about Shenling baizhu powder combined with aminosalicylic acid preparations (trial group) vs. aminosalicylic acid preparations alone (control group) in the treatment of UC were collected. Meta-analysis was performed by using Rev Man 5.2 statistical software after data extraction and quality evaluation with Cochrane systematic evaluator manual 5.1.0. RESULTS: A total of 14 RCTs were included, involving 1 177 patients. Meta-analysis showed that total response rate of trial group was significantly higher than that of control group [OR=3.40, 95%CI(2.44,4.74),P<0.001], while Sutherland DAI score [MD=-1.31,95%CI(-2.07,-0.56),P<0.001], the levels of TNF-α [SMD=-1.90,95%CI(-2.90,-0.90),P<0.001], IL-17[MD=-85.18,95%CI(-100.51,-69.85),P<0.001] and IL-23 [MD=-113.27,95%CI(-132.34,-94.21),P<0.001] in trial groups were significantly lower than control group, with statistical significance. CONCLUSIONS: Therapeutic efficacy of Shenling baizhu powder combined with aminosalicylic acid preparation is better than aminosalicylic acid preparation alone in the treatment of UC, and can significantly reduce Sutherland DAI and the levels of serum cytokines.
参苓白术散氨基水杨酸制剂溃疡性结肠炎随机对照试验Meta分析疗效
Shenling baizhu powderAminosalicylic acid preparationsUlcerative colitisRandomized controlled trialsMeta-analysisTherapeutic efficacy
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