本文選題：中醫(yī)藥 + 中西醫(yī)結(jié)合�。� 參考：《湖北中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:中醫(yī)藥治療原發(fā)性膽汁性肝硬化(Primary biliary cirrhosis,PBC)雖然具有一定的成效,但是仍處于探索階段,缺乏系統(tǒng)規(guī)律的標準和循證學(xué)依據(jù)。通過Meta分析整合小樣本臨床實驗研究,擴大樣本量,進而得出更加可靠的結(jié)論,為臨床PBC的中醫(yī)藥治療提供一定的參考。方法:檢索Medline、Embase、Pubmed、Cochrane Library、維普、中國知網(wǎng)、萬方、中醫(yī)藥在線等數(shù)據(jù)庫中有關(guān)中醫(yī)藥或中西醫(yī)結(jié)合治療PBC的隨機對照實驗的文獻及會議論文。兩名研究員單獨進行文獻篩選、質(zhì)量評估并提取信息資料,采用改良Jadad量表行文獻質(zhì)量評估。選取有效率、肝功能、肝纖維化指標以及免疫學(xué)指標為療效指標。采用Rev Man5.3軟件對數(shù)據(jù)進行處理,選用比值比(Odds ratio,OR)及95%可信區(qū)間(Confidence interval,CI)表示二分類計數(shù)資料,以加權(quán)均數(shù)差(Weighted mean difference,WMD)及其95%可信區(qū)間(Confidence interval,CI)表示連續(xù)計量資料。結(jié)果:最終納入了39篇符合要求的文獻,總樣本量為2434,高質(zhì)量文獻4篇,低質(zhì)量文獻35篇;對照組均予以熊去氧膽酸(Ursodeoxycholic acid,UDCA)治療作為條件對照,實驗組在對照組的基礎(chǔ)上加用中藥湯劑或中成藥治療;Meta分析結(jié)果顯示實驗組與對照組在有效率、肝功能、肝纖維化指標以及免疫學(xué)指標Ig M、Ig G的比較中有顯著性差異,在免疫學(xué)指標2型抗線粒體抗體(AMA-M2)比較中無顯著性差異。結(jié)論:UDCA在PBC的治療中仍然起著舉足輕重的地位;中醫(yī)藥治療PBC無外乎以扶正祛邪為根本治療大法,扶正則以滋補肝腎、益氣養(yǎng)血為主;祛邪則以清利濕熱、活血化瘀、舒肝理氣為主;中西醫(yī)結(jié)合治療PBC在提高有效率,改善肝功能、肝纖維化指標以及某些免疫學(xué)指標方面比單純使用西藥更有優(yōu)勢。
[Abstract]:Objective: traditional Chinese medicine (TCM) in the treatment of primary biliary cirrhosis is still in the stage of exploration, and lacks the standard of systematic law and the evidence based basis. Through Meta analysis and integration of small samples of clinical experimental research, expand sample size, and then draw a more reliable conclusion, for clinical PBC treatment of traditional Chinese medicine to provide a certain reference. Methods: the literatures and conference papers on randomized controlled trials of Chinese medicine or combination of traditional Chinese medicine and western medicine for PBC were searched in Medlinea Embase Pubmedmedmeda Cochrane Library, Weip, China Zhiwang, Wanfang, and Chinese Medicine online. The two researchers conducted literature screening, quality assessment and extraction of information data separately. The modified Jadad scale was used to evaluate the literature quality. The effective rate, liver function, liver fibrosis index and immunological index were selected as therapeutic indexes. The Rev Man5.3 software was used to process the data. The ratio of odds ratio (odds ratio) and 95% confidence interval (CI) were used to represent the two classified counting data, and the weighted mean difference (weighted mean difference) and 95% confidence interval (CI) were used to represent the continuous measurement data. Results: 39 articles were included, the total sample size was 2434, the high quality literature was 4, the low quality literature was 35, and the control group was treated with Ursodeoxycholic acid (UDCA) as a condition control, and the control group was treated with ursodeoxycholic acid (UDCA). The results of Meta-analysis showed that the effective rate, liver function, liver fibrosis index and immunological index Ig MMC Ig G were significantly different between the experimental group and the control group. There was no significant difference in immunological index type 2 anti mitochondrial antibody (AMA-M2). Conclusion: the treatment of PBC still plays an important role in the treatment of PBC. The traditional Chinese medicine treatment of PBC is nothing more than the treatment of nourishing the qi and kidney, nourishing the liver and kidney, nourishing qi and nourishing the blood, and dispelling evil by clearing away dampness and heat, activating blood circulation and removing blood stasis. The combination of traditional Chinese and western medicine has more advantages in improving the effective rate, improving liver function, liver fibrosis index and some immunological indexes than using western medicine alone.
【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】：R575.2

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