半夏瀉心湯治療慢性胃炎臨床觀察回顧研究
發(fā)布時間：2018-08-31 11:53
【摘要】：目的:通過統(tǒng)計分析近十年發(fā)表的半夏瀉心湯治療慢性胃炎的臨床觀察文獻,探討國內(nèi)半夏瀉心湯治療慢性胃炎的研究狀況,明確半夏瀉心湯治療慢性胃炎發(fā)展方向,為將來臨床治療提供更有力的參考。方法:檢索CNKI《中國醫(yī)院數(shù)字圖書館》從2007年01月-2016年12月關于半夏瀉心湯治療慢性胃炎的臨床觀察文獻,將符合納入條件的文獻中所涉及的相關數(shù)據(jù)全部錄入Excel 97-2003版數(shù)據(jù)庫,應用文獻計量學和循證醫(yī)學以及統(tǒng)計學方法,對符合標準的半夏瀉心湯治療慢性胃炎臨床觀察類文獻的分布年代和比例、臨床試驗設計情況(包括文獻的樣本含量、隨機化原則、對照原則、盲法、均衡性、統(tǒng)計學檢驗方法、毒副作用、并發(fā)癥、不良反應、隨訪以及復發(fā)率)、診斷標準、納入/排除標準、辨病類型、中醫(yī)辨證分型、臨床試驗用藥(中藥、中成藥及西醫(yī))、療效評判標準、臨床治療效果等各方面進行統(tǒng)計分析。結果:1.累計檢索符合納入條件的半夏瀉心湯治療慢性胃炎的臨床觀察文獻共232篇,共計病例為24312例;2.臨床設計情況:樣本含量在60-99例的文獻有107篇,約占46.2%;有190篇文獻運用隨機化原則,約占81.9%;有164篇文獻提及“對照組”,約占70.6%;共有121篇文獻進行了均衡性比較,約占52.2%;所有納入文獻中只有1篇提及盲法,為雙盲;有13篇文獻敘述并發(fā)癥,約占5.6%;其中只有1篇文獻提及毒副作用;有7篇文獻有隨訪記錄,約占3%;累計有58篇文獻提及不良反應,約占25.0%;3.所納入的文獻中共有145篇文獻無明確診斷標準,約占62.5%;有122篇文獻無納入/排除標準,約占52.6%。應用臨床癥狀作為評價參照的文獻為226篇,約占97.4%;以內(nèi)鏡下診斷作為評價指標的有196篇,約占84.5%;以病理作為療效依據(jù)的有43篇,約占18.5%;以Hp清除率為評價標準的有39篇,約占16.8%;以癥狀評分作為評價指標有26篇,約占11.2%;4.納入文獻中,有126篇明確慢性胃炎的類型,約占54.3%;其中明確慢性萎縮性胃炎的文獻有63篇,約占27.2%;慢性淺表性胃炎的文獻有54篇,約占23.3%;合并以上兩種胃炎的文獻有21篇,約占9.1%;有15篇文獻為Hp感染相關性胃炎,約占6.5%;5.有195篇文獻進行了臨床證型分類,共出現(xiàn)35種證候類型,其中出現(xiàn)前三名的為寒熱錯雜證、肝胃不和證、脾胃濕熱證;按照虛實分析,虛實夾雜證證型共182次,實證證型共140次,虛證證型共83次,各占證型總數(shù)的44.9%、34.6%及20.5%;6.所有納入文獻中一共涉及中藥245種,累計頻次5490次,以半夏、甘草、黃連、白術使用次數(shù)最多(200次),黨參、黃芩、柴胡、陳皮、白芍、大棗次之(150次),藥物主要以補虛藥、理氣藥、清熱藥物為主;其中合并使用方劑出現(xiàn)較多的為四逆散與左金丸;7.常用西藥為奧美拉唑、阿莫西林、克林霉素出現(xiàn)次數(shù)最多(40次),其次為枸櫞酸鉍鉀、蘭索拉唑、雷貝拉唑等。常用中成藥為胃復春片、三九胃泰顆粒等;8.療效分析:半夏瀉心湯治療慢性胃炎具有顯著臨床效果。結論:1.近十年來半夏瀉心湯治療慢性胃炎臨床觀察文獻呈上升趨勢,取得良好的研究進展;但大多數(shù)文獻的臨床研究設計存在不足,樣本含量偏小,對于不良反應、毒副作用、并發(fā)癥、隨訪以及復發(fā)率等臨床關鍵組成構件存在嚴重缺失,臨床診斷以及療效評價缺乏循證醫(yī)學依據(jù)的統(tǒng)一標準,指南共識的采用較少,使得研究結果可能存在偏倚。2.半夏瀉心湯不僅可以緩解患者的腹痛、腹脹、呃逆等不適癥狀,對于幽門螺桿菌清除也有一定作用,能促進胃黏膜的炎癥修復,使已萎縮或腸化的腺體恢復正常,對于慢性胃炎具有顯著臨床療效。
[Abstract]:OBJECTIVE:To analyze the clinical observation literature of Banxia Xiexin Decoction on chronic gastritis published in the last ten years,to explore the research status of Banxia Xiexin Decoction on chronic gastritis in China,to clarify the development direction of Banxia Xiexin Decoction on chronic gastritis,and to provide more powerful reference for clinical treatment in the future. Guan > From January 2007 to December 2016, the clinical observation literature on Banxia Xiexin Decoction in treating chronic gastritis was recorded in Excel 97-2003 edition database. Bibliometrics, evidence-based medicine and statistical methods were applied to treat chronic gastritis with Banxia Xiexin Decoction. Distribution age and proportion of clinical observation literature, clinical trial design (including sample content, randomization principle, control principle, blind method, balance, statistical test method, toxicity, side effects, complications, adverse reactions, follow-up and recurrence rate), diagnostic criteria, inclusion/exclusion criteria, disease type, syndrome differentiation of traditional Chinese medicine, clinical practice Results: 1. A total of 232 clinical observation literatures of Banxia Xiexin Decoction in treating chronic gastritis were retrieved, with a total of 24312 cases; 2. Clinical design: 107 literatures with 60-99 samples. About 46.2%; 190 papers used randomization principle, accounting for 81.9%; 164 papers referred to the "control group", accounting for 70.6%; 121 papers were compared equally, accounting for 52.2%; only one of them mentioned blindness, which was double blindness; 13 papers described complications, accounting for about 5.6%; only one of them referred to toxic side effects. 7 literatures had follow-up records, accounting for 3%; 58 literatures mentioned adverse reactions, accounting for 25.0%; 3. 145 literatures included in the literature did not have clear diagnostic criteria, accounting for 62.5%; 122 literatures did not include / exclude criteria, accounting for 52.6%. 226 literatures used clinical symptoms as evaluation reference, accounting for 97.4%; endoscopy. There were 196 (84.5%) cases as evaluation index, 43 (18.5%) cases based on pathology, 39 (16.8%) cases based on Hp clearance rate, 26 (11.2%) cases based on symptom score, and 126 (54.3%) cases of chronic gastritis. There were 63 papers on constrictive gastritis, accounting for 27.2%; 54 papers on chronic superficial gastritis, accounting for 23.3%; 21 papers on combination of the two gastritis, accounting for 9.1%; 15 papers on HP infection-related gastritis, accounting for 6.5%; 5.195 papers on clinical syndrome classification, a total of 35 types of syndrome, of which the top three appeared. According to the analysis of deficiency and excess, deficiency and excess combined with syndromes were 182 times, 140 times and 83 times respectively, accounting for 44.9%, 34.6% and 20.5% of the total syndromes; 6. All of the Chinese medicines involved in the literature, a total of 245 times, a total of 5490 times, Pinellia ternata, Glycyrrhiza uralensis, Coptis chinensis, and Atractylodes macrocephala were the most frequently used. Radix Codonopsis, Radix Scutellariae, Radix Bupleuri, Cortex Citri, Radix Paeoniae Alba, Dazao (150 times), the main drugs to tonify the deficiency, Qi-regulating drugs, antipyretic drugs; Sini powder and Zuojin pills were more commonly used in combination; 7. Omeprazole, amoxicillin, clindamycin appeared most frequently in Western medicine (40 times), followed by bismuth potassium citrate, Lansopra. Zuo, Rabeprazole, et al. The commonly used Chinese patent medicine is Weifuchun tablets, Sanjiuweitai granules, etc. 8. Therapeutic effect analysis: Banxia Xiexin Decoction has a significant clinical effect on chronic gastritis. Conclusion: 1. In the past decade, Banxia Xiexin Decoction for chronic gastritis clinical observation literature showed an upward trend, made good progress; but most of the literature of clinical research settings; There are serious deficiencies in clinical key components such as adverse reactions, toxic and side effects, complications, follow-up and recurrence rates, lack of uniform standards for evidence-based medicine in clinical diagnosis and efficacy evaluation, and less consensus on guidelines, which may lead to bias in the results of the study. 2. It can only relieve abdominal pain, abdominal distention, hiccup and other discomfort symptoms of patients, also has a certain role in clearing Helicobacter pylori, can promote the repair of gastric mucosa inflammation, make atrophic or intestinal glands to return to normal, for chronic gastritis has a significant clinical effect.
【學位授予單位】：廣西中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R259
本文編號：2214903
[Abstract]:OBJECTIVE:To analyze the clinical observation literature of Banxia Xiexin Decoction on chronic gastritis published in the last ten years,to explore the research status of Banxia Xiexin Decoction on chronic gastritis in China,to clarify the development direction of Banxia Xiexin Decoction on chronic gastritis,and to provide more powerful reference for clinical treatment in the future. Guan > From January 2007 to December 2016, the clinical observation literature on Banxia Xiexin Decoction in treating chronic gastritis was recorded in Excel 97-2003 edition database. Bibliometrics, evidence-based medicine and statistical methods were applied to treat chronic gastritis with Banxia Xiexin Decoction. Distribution age and proportion of clinical observation literature, clinical trial design (including sample content, randomization principle, control principle, blind method, balance, statistical test method, toxicity, side effects, complications, adverse reactions, follow-up and recurrence rate), diagnostic criteria, inclusion/exclusion criteria, disease type, syndrome differentiation of traditional Chinese medicine, clinical practice Results: 1. A total of 232 clinical observation literatures of Banxia Xiexin Decoction in treating chronic gastritis were retrieved, with a total of 24312 cases; 2. Clinical design: 107 literatures with 60-99 samples. About 46.2%; 190 papers used randomization principle, accounting for 81.9%; 164 papers referred to the "control group", accounting for 70.6%; 121 papers were compared equally, accounting for 52.2%; only one of them mentioned blindness, which was double blindness; 13 papers described complications, accounting for about 5.6%; only one of them referred to toxic side effects. 7 literatures had follow-up records, accounting for 3%; 58 literatures mentioned adverse reactions, accounting for 25.0%; 3. 145 literatures included in the literature did not have clear diagnostic criteria, accounting for 62.5%; 122 literatures did not include / exclude criteria, accounting for 52.6%. 226 literatures used clinical symptoms as evaluation reference, accounting for 97.4%; endoscopy. There were 196 (84.5%) cases as evaluation index, 43 (18.5%) cases based on pathology, 39 (16.8%) cases based on Hp clearance rate, 26 (11.2%) cases based on symptom score, and 126 (54.3%) cases of chronic gastritis. There were 63 papers on constrictive gastritis, accounting for 27.2%; 54 papers on chronic superficial gastritis, accounting for 23.3%; 21 papers on combination of the two gastritis, accounting for 9.1%; 15 papers on HP infection-related gastritis, accounting for 6.5%; 5.195 papers on clinical syndrome classification, a total of 35 types of syndrome, of which the top three appeared. According to the analysis of deficiency and excess, deficiency and excess combined with syndromes were 182 times, 140 times and 83 times respectively, accounting for 44.9%, 34.6% and 20.5% of the total syndromes; 6. All of the Chinese medicines involved in the literature, a total of 245 times, a total of 5490 times, Pinellia ternata, Glycyrrhiza uralensis, Coptis chinensis, and Atractylodes macrocephala were the most frequently used. Radix Codonopsis, Radix Scutellariae, Radix Bupleuri, Cortex Citri, Radix Paeoniae Alba, Dazao (150 times), the main drugs to tonify the deficiency, Qi-regulating drugs, antipyretic drugs; Sini powder and Zuojin pills were more commonly used in combination; 7. Omeprazole, amoxicillin, clindamycin appeared most frequently in Western medicine (40 times), followed by bismuth potassium citrate, Lansopra. Zuo, Rabeprazole, et al. The commonly used Chinese patent medicine is Weifuchun tablets, Sanjiuweitai granules, etc. 8. Therapeutic effect analysis: Banxia Xiexin Decoction has a significant clinical effect on chronic gastritis. Conclusion: 1. In the past decade, Banxia Xiexin Decoction for chronic gastritis clinical observation literature showed an upward trend, made good progress; but most of the literature of clinical research settings; There are serious deficiencies in clinical key components such as adverse reactions, toxic and side effects, complications, follow-up and recurrence rates, lack of uniform standards for evidence-based medicine in clinical diagnosis and efficacy evaluation, and less consensus on guidelines, which may lead to bias in the results of the study. 2. It can only relieve abdominal pain, abdominal distention, hiccup and other discomfort symptoms of patients, also has a certain role in clearing Helicobacter pylori, can promote the repair of gastric mucosa inflammation, make atrophic or intestinal glands to return to normal, for chronic gastritis has a significant clinical effect.
【學位授予單位】：廣西中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R259
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