中医药治疗慢性胆囊炎的系统评价及启示
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第二军医大学附属长海医院,上海200433

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R2564

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A Systematic Review of Randomized Controlled Trial in Treating Chronic Cholecystitis with TCM
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Department of Traditional of Chinese Medicne,Changhai Hospital, Second Military Medical University,Shanghai 200433,China

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    摘要:

    目的:评价中医药治疗慢性胆囊炎的疗效和安全性。方法:计算机检索MEDLINE,EMBASE,CENTRAL,CBM,CNKI、VIP,万方数据库。检索不受语种限制,时间截止至2010年1月。两位作者按纳入排除标准筛选试验、评价纳入研究的质量,提取有效数据,并用Cochrane协作网提供的RevMan4210软件对资料进行Meta-分析。结果:最终纳入9个中医药治疗慢性胆囊炎的随机对照试验(RCT),共1 376例患者,所纳入的文献质量偏低。临床指标:1、死亡率:纳入的9篇RCT均无报道死亡率。2、治愈率:纳入7个研究,结果显示中医中药治疗组治愈率高于常规西药治疗组。3、总有效率:中医中药治疗组与常规西药组之间的比较,共纳入7个RCT,差异有统计学意义。中医中药加西药组与西药组之间的比较,共纳入2个RCT,结果显示差异没有统计学意义(P=009)。4、平均住院时间:1个RCT报道了平均住院时间。5、疼痛积分:两组疼痛积分均有统计学意义,说明中医中药组及中药加西组在减轻疼痛的指标上优于单纯西药组。6、不良反应:9篇研究均未报道不良反应。结论:纳入本系统评价的研究表明中医药能提高慢性胆囊炎的治愈率及总有效率,缩短平均住院时间及改善疼痛积分。但是本研究中的随机对照试验研究质量较低,所以,对于中医药治疗慢性胆囊炎需设计多中心的随机的严格的临床试验进一步来验证及推广或者研究一种更符合有关中医药的系统评价系统。

    Abstract:

    Backgrounds: Surgical cholecystectomy is the main treatment of recurrent attacks chronic lithogenous cholecystitis. For those who do not want surgery, symptoms of mild non-recurrent or chronic cholecystitis which do not together with polyps, stones, the use of anti-inflammatory, choleretic, antispasmodic pain and other symptomatic treatment, but poor efficacy in some patients, often defer many years ,affect the quality of life. Seek a more effective method is of great significance. Objective: To evaluate the efficacy and safety of Traditional Chinese Medicine in treating of Chronic cholecystitis. Review methods:We searched MEDLINE,EMBASE. The Cochrane Library (CENTRAL), CBM,CNKI,VIP,Wangfang. No language restrictions were applied. Screen trial Trial screening, according to exclusion and included criteria, quality assessment of included trials, and data extract were managed. Statistical analysis was performed by using Meta-analysis. Results:Results: A total of 9 Chinese medicine treatment of chronic cholecystitis of randomized controlled trials (RCTs) in the Chinese language were identified. a total of 1376 cases of patients, which included. Low quality literature. Clinical indicators: 1, the mortality rate: All the nine RCT reported no mortality. 2, the cure rate: study included 7 showed that the cure rate of Chinese medicine treatment group better than in the conventional western medicine. 3, the total efficiency: Chinese medicine treatment group and the comparison between conventional western medicine group, 7 RCTs were included, the difference was statistically significant. The comparison between Western medicine combine with Chinese medicine and western medicine , the total two RCTs are incuded, the results showed no statistically significant difference (P = 009). 4, the average length of stay: one RCT reported an average length of stay. 5, pain points: the two groups pain scores were statistically significant, indicating that group of Chinese medicine and Chinese medicine combine with Western medicine in relieving pain part are better than western medicine on the target group. 6, the adverse reaction: nine studies did not report adverse reactions Conclusion:ncluded in this systematic review of research shows that Chinese medicine can improve the cure rate of chronic cholecystitis and total efficiency, reduce the average length of stay and improved pain scores. However, to this study randomized controlled trials, further high quality trails are needed, for the treatment of chronic cholecystitis using TCM need to design rigorous multi-center randomized clinical trial or for further studies to validate and promote a more systematic reviews on TCM system.

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