摘要
目的系统评价中成药治疗胆石症的有效性和安全性。方法计算机检索MEDLINE(1966～2009.2)、EMbase(1974～2009.2)、Cochrane图书馆(2008年第4期)、中国生物医学文献数据库(1978～2009.2)、中国期刊全文数据库(1994～2009.2)、中文科技期刊数据库(1989～2009.2)、中文生物医学期刊数据库(1994～2009.2),并追索纳入文献的参考文献和相关文献,纳入中成药治疗胆石症的随机对照试验,利用Cochrane手册5.0推荐的"偏倚风险评估"工具对纳入研究进行质量评价。对同质研究采用RevMan5软件进行Meta分析,对非同质资料进行描述性分析。结果共纳入18篇文献,均为随机对照试验,共2276例患者。根据测量指标、干预措施进行亚组分析,结果显示,10个研究报道了有效率,提示部分中成药治疗胆石症有效率较高。5个研究比较了胆囊排空指数及胆汁成石趋势,提示中成药降低胆汁的致石指数,从而缓解了胆汁的致石倾向。3个研究报道了胆囊收缩率,Meta分析结果提示差异有统计学意义。2个研究报告了上腹不适、腹泻等不良反应,大部分较轻微,可自行缓解。结论中成药对于胆石症患者临床症状,胆囊功能的改善及降低胆汁成石趋势有一定疗效,但对长期疗效的报道较少。鉴于当前相关研究方法学质量不高,同质性较差,其结论尚需进一步验证。
Objective To evaluate the effectiveness and safety of Chinese medicine treatment of cholelithiasis. Methods We searched electronic databases including MEDLINE （1966 to Feb. 2009）, EMbase （1974 to Feb. 2009）, The Cochrane Library （Issue 4, 2008）, Chinese Biomedical Literature Database （CBM, 1978 to Feb. 2009）, CJFD （CNKI, 1994 to Feb. 2009）, the Chinese Scientific and Technical Journals database （VIP, 1989 to Feb. 2009）, and a database of Chinese biomedical journals （CMCC, 1994 to Feb. 2009）. At the same time, we searched references of the included studies. Meta-analysis was performed using RevMan 5 if there was no significant heterogeneity. We described the date which could not be combined. Results A total of 18 randomized controlled trials involving 2 276 patients were included. According to measurement indicators and interventions, subgroup analysis was performed. Efficacy was reported in 10 studies, which showed that part of proprietary Chinese medicines had a higher efficiency for cholelithiasis. Gallbladder emptying index and the trend of bile into the stone were compared in 5 studies, suggesting that the bile of proprietary Chinese medicines reduced the stone index, which eased the bile tendency to rock. Three studies reported the rate of cholecystokinin. Meta-analysis results suggested that the difference was significant. Two studies reported adverse drug reactions （ADRs）, such as epigastric discomfort and diarrhea. Most ADRs were slight, and could be self relieved. Conclusion Results suggest that Chinese medicines produce effects on clinical symptoms of cholelithiasis, gallbladder function and reduce the trend of bile into stones. However, the therapeutic effects for long-term are rarely reported. The conclusion needs further verification due to low methodological quality and apparent heterogeneity.
出处
《中国循证医学杂志》
CSCD
2010年第3期356-361,共6页
Chinese Journal of Evidence-based Medicine
关键词
胆石症
中成药
系统评价
Cholelithiasis
Chinese medicine
Systematic review
