| BackgroundThe ache is chronic inflammation and illness of the sebaceous glands of a kind of hair follicle, is more than one kind of reason diseases. Like to send and carry the position in teenagers' face and chest, it is not merely a kind of body disease, it influences patient's capital in such aspects as social activity, psychology, mood. There are a lot of kinds of laws of managing in Western medicine in the acne, but because its side effect is great, so a lot of patients seek the treatment of Chinese medicine in the realistic environment. Treat and pass thousands of years it so far in Chinese medicine: As time develops, a lot of traditional Chinese medicine documents are issued. But what for where be false really among here a large number of document, what documents are correct, it is clinical workers that care it is what the people expect too. Because the research of studying the respect of the method is comparatively weak in these documents, the method and appraisal means to study is scarce and regulatory, have influenced the authenticity and repetitiveness of the conclusion of studying to a certain extent, it is difficult for the result of study to get the domestic and international medical circle to admit, have influenced Chinese medicine to move towards the world, move towards the modernization greatly. Follow medical science of the card and network analysis method and result and getting the approval and attention of the international medical circle and decision department of the hygiene day by day, is it follow card medical science, method of network analysis to utilize, take out Meta person who analyse data, there are greater realistic meanings to move towards the world to the traditional Chinese medicine of promoting.ObjectiveThe purpose that this system appraises is here by following the method analysed in card medical science, network analysis and Meta, appraise the clinical curative effect and security to traditional Chinese medicine or the therapy of combining traditional Chinese and Western medicine acne.Methods1.Appraise systematically1.1 document sourcesAll clinical research documents related to ache at home from 1994 to December of 2005. Major paper is check from CBM disc and CNKI Web. And for peventing lossing paper, the author is looking for nine journal. The CD database does not have original text and can be downloaded, go to the library of traditional Chinese medicine university of Guangzhou and national library of Taipei through searching and getting the original text by hand, and then screen and combine the clinic which treat the ache and contrast the research document domestically about traditional Chinese medicine and Chinese and Western. The end search date once of once is January 12, 2006 finally.1.2 adopt and search the tactics mainlyUse keywords and theme word mainly (The ache, Cuo's prickly heat, acne) Search all documents alternately, including massotherapy, traditional Chinese breathing exercise, point treatment, acupuncture and moxibustion treatment, combine traditional Chinese and western medicine treatment, traditional Chinese medicine treatment, traditional Chinese medicine treatment, Chinese medicine treatment, etc. manage French offer. Also include all such documents as all at random, contrasting or blind laws, etc.; Divide core or key periodical intact in order to their. 1.3 documents are included in the standardRead tentatively first, the content of the article is briefed on the clinical research report with the acne; It' s materials content, in order to contrast at random; There is certain sample amount that makes statistical analysis while studying. The content of the article relies mainly on the fact that traditional Chinese medicine treats and combines the treatment method with the midwest mainly.1.4 documents reject the standardSurvey documents; Have not contrasted a group of documents; Documents not doing statistical analysis while studying; Repeat the report; Case report; The animal tests; The theory probes into documents; Documents of summary of experience; to only managing the law simply with Chinese medicine. External. application, acupuncture and moxibustion, massage, qigong, etc. Documents no the record. Pure Western medicine treats documents.1.5 appraises the methodAccording to shine on bed epidemiology / DME principle and method that method study, make a unified one, norm" traditional Chinese medicine treat ache document system appraise form", It accords with and studies all clinic treating documents needed to screen, assign to in order to contrast the group at random (Randomized Controlled Trial; RCT), random comparative study non(ControlledClinicalTrial; CCT), and not the comparative study, read analysing to all documents. Main content that " think form " to contrast and test to all clinic at random, make the general situation like the disease of project about designing requirement of scientific research, Chinese medicine or Western medicine diagnostic standard, the experiment includes the standard in or gets rid of, intervening measure type, contrast the therapeutical situation, the content of the sample is estimated in advance, the application, application of the statistics method, curative effect of the harmony, situation at random, blind law judge the standard etc. to include in the assessment of documents among the groups. 2 traditional Chinese medicine and Chinese and Western combine Meta analysis of treating the acne2.1 research objectsDomestic all is it is it is it treat clinical random document that comparative study be tested, ache of disease to combine about traditional Chinese medicine and Chinese and Western to happen to examine at computer to 2008 since the 1994. Including critria standartion: 1. Major including the treatment of chinese medicne and chinese and westernal medicine randomized controlled trial. Diagnose clearly it is an ache: And there must be documents treating in traditional Chinese medicine. (Generally treat or other effective pertinence are treated as contrast: (The harmony among the groups is better, have comparativity. (treat way whether traditional Chinese medicine or Chinese and Western combine or cure the method mainly at getting rid of standard; And the one that treat the way and manage the law for Chinese medicine simply mainly. (Have not set up and contrasted the group or contrasted the group and treated the persons who have not made it clear of the way. (The harmony among the groups is bad, two groups of persons who doesn't have comparativity; ()It is not obvious and announcing to the person who treats result in detail that it is not clear that curative effect evaluates the indicator.Draw the method in clinical document data: The above two professional researchers drew forms according to the materials made, relevant data materials are collected independently. Revman4.8 that offer by Cochrane coorporative network and then count software, adopt data pair input law analyse Meta at the data-in. Analyse in accordance with the susceptibility of different designing quality, draw the funnel picture and analyse the issuing is partial.Results1.Appraise systematicallyPass 2 computer databases (CBM disc and CNKI) Examine with hands; The Communist Party of China got 3925 documents of acne since 15, via reading the full text according to including in the document standard and getting rid of the standard of documents, receive 2442 articles of clinical experiment. Is it is it is it is it go on to come to treat to combine to traditional Chinese medicine or Chinese and Western mainly to appraise originally, so not record pure documents that treat by way of Western medicine of Western medicine, it is 1016altogether studied with pure Western medicine in 2442 documents, 1426 account for clinical 58.4% which treat the total record of documents to receive traditional Chinese medicine and deal with or combine traditional Chinese and western medicine to deal with altogether after deducting. And then look over of 1426 whether there is contrast that is dealt with, contrast deals with and amounts to 531, contrast does not deal with 895. 531 include and contrast in documents the office divides and analyses at random. In 249 documents contrasted at random, because this research relies mainly on managing in traditional Chinese medicine, so get rid of documents managed outside simple Chinese medicine, 183 left are entered and analysed.Study the purpose, it is all the confirmation on curative effect. On the diagnostic standard, 183 have 78 RCT document not to have clear Chinese medicine diagnostic standard, there is not a diagnostic standard of Western medicine, accounts for 42.6% altogether: Use 31 of the diagnostic standard of Chinese medicine simply, take 16.9%; Use 51 of the diagnostic standard of Western medicine simply, take 27.9%; Traditional Chinese and western medicine that diagnostic standard adopt to have 23, 12.6%. And then analyse 33 are national standards in the diagnostic standard of Chinese medicine, i for local academic meeting, is it make standard, for textbook, or other authoritative academic standard that books made 20 to learn. Western medicine is among diagnostic standard, let's have 39 piece in all standard not internationally acknowledged, 3 pieces for to academic meeting not local, learn standard of making, 32 are standards of textbooks. There are 24 clear, suitable to include in the standard documents, 159 documents have not been described and included in the standard. 32 documents have' confirm clear, suitable including in the standard, and relate to study the purpose': There are the standards of getting rid of of 3 but ' certain standard of getting rid of, but deficient'; 148 documents have not described the standard of getting rid of. It is suitable to include in the standard to be have from 183 documents that are screened, there is rational clear getting rid of standard documents that there are 17, accounts for 9.3%; No description includes in the standard and not describes that it is 142 to get rid of standard documents, accounts for 77.6%.183 pieces of random comparative study adopt the clinical method that contrast. In the elected are studied, the contrast of having 120 documents is rational, accounts for 65.6%; A contrast of research is unreasonable, accounts for 0.5%, 62 research are unable to judge the rationality contrasted, accounts for 33.9% in documents. 161 to contrast a group of only ones in 183 here; And 2 contrast group 22ing aboveMost sample is it treat group and contrast content of group among 50-300, treat sample of group content 5 in 10-50 among them to include, accounting for 2.73%, it is 167 in 51-300, accounts for 88.52%; To have 16 in all, account for 8.74% of total amount this 300 and a half case of. The screening of having the case of no document is written down, has not written down the estimation that any document referred to the content of sample in advance either. The harmony relativelies among the groups, the great majority have not been mentioned and compared proportionally among the groups. 183 are contrasted at random in documents, there are the demographic complete characteristics of 8 documents, accounts for 4.37%, have 173 propose demographic characteristic is it account for 94.53% totally partly to belong to, has not have 2 mention demographic characteristic while being other, accounts for 1.09%. The parameter respect of the condition, there are 11 relatively complete documents, occupy 6.01%, have 1 condition parameter as part, account for 0.54%; Has not it mention patient condition parameter to have all while being other. In waiting the research of the type in card, 18 documents study the case of the single card type, take 9.84%. 21 documents refer to the fen type with dialectical Chinese medicine, accounts for 11.48. And chinese paper have no pattarn dividing is 78.69%。Analysis of the balanced base-line among the groups that all 183 documents have not been made. But have content of 121 articles that mentions that contrast and treat the group among them, it is constant, have no difference, accounts for 66.12%. Author is it is it is it contrast group, treat group count P value ?2 to measure to list to have in 121 of here, and ?2 this is it withdrawPvalue source statistical method only 6, 6 this is it mention statistical method have X2 examine, Ridit is examined, t is examined to have to have.In assign result simple to at random, have divide layers of at random, granule at random or half at random all at the method at random. And all state at random in the article. In the random array produces the appraisal of the method; Totally there are 12 in all at random to use, accounts for 6.55% of total amount. Adopt the not seeing of half a random method. 7here are 22 in all at random false to use, accounts for 12.0% totally. 149 documents left have not been all described, the content is only stated and assigned at random, at random, accounts for 81.42% totally. The ones that assigned at random are invisible, read the last all documents in details, has not all described to. Only one refers to blind law, and it is blind that the content is only increased to three, detailed blind law is.not described.Or combine traditional Chinese and western medicine to manage the law for Chinese medicine in 183 research, can is it cure to cooperate also besides managing inside on Chinese medicine treat; In Chinese medicine combines Western medicine documents, Western medicine can also be particularly managed or managed inside; So therefore 183 in accordance with with Chinese medicine manage, Western medicine manage, Western medicine manage and arrange analysing and then. Manage 63 to take 34.43% in single Chinese medicine; Chinese medicine manage + Chinese medicine is it have 39 account for 21.31% to manage: Chinese medicine manage + Western medicine is it have 16 account for 8.74% to manage: Chinese medicine manage + Western medicine is it have 35 account for 19.13% to manage; Chinese medicine manage + Chinese medicine manage + Western medicine is it have 8 account for 4.37% to manage: Chinese medicine manage + Chinese medicine manage + Western medicine is it have 10 account for 5.46% to manage; Chinese medicine manage + Western medicine manage + Western medicine is it have 12 account for 6.56% to manage: Chinese medicine manage + Chinese medicine manage + Western medicine manage + Western medicine manage having. Standardize in intervening measure and the stability, several respects of conforming with the square card from composition, form of a drug, consumption, usage, course of treatment, way of using medicine of the square medicine mainly etc. have been appraised, treat group standardization good 13, account for 7.1%, better 31, accounting for 16.94%, i05 the general ones, accounts for 57.38%, worse 16 take 8.74%. It 10 account for 5.46% to describe what lacks very muches; 8 that can't be judged account for 4.37%.It all damages and judges the standard for curative effect with the skin to select 183 documents: Among them adopt 38 national standards, accounts for 20.8%; And there is one standard of adopting the local academic meeting, learning to be made: There are 9 standards of adopting the textbook, other authoritative academic books and making; 135 all charge the standard planned by oneself while being other.In the indicator of judging of curative effect, 183 all decrease and disappear a few percent as judging the indicator with the cover, among them curative effect judges dependence of the indicator and research purpose is all relevant, and main curative effect judges the indicator is all rational. Have not been all tried to looking like complying with test in 183 documents. There are only 3 written down cases for withdrawing and losing visiting, coming off. While following up a case by regular visits to and appraising of 183, have 11 to follow up a case by regular visits to to register; Accounts for 6%.183 contrast document carry on treatment of statistics there are 173 to data at random, accounting for 94.53%, nly 10 documents have not carried on the treatment of statistics, the methods used have card side's examining, t examining, Ridit analysis, order and examining, etc.. Statistics method that all documents have not been confirmed in advance. No document uses the statistics method to correct to the variable of the harmony among the groups. The concrete statistics amount of inspection provides 5 and accounts for 2.73% with P value; And provide concrete inspection statistics amount and P value in the range, there are 158 to but not provided concrete P value, accounts for 86.34%; It only 19 account for 10.38% to examine the counting amounts; There is one ranges to only have P value, accounts for 0.55%.Have not all confirmed statistical method in advance in all documents. Also there is not one that use statistics methods to correct to the balanced parameter among the groups. There are not negative results that there are 173; But there are 10 negative result; But negative to fruit indicator is it go on after testing counting efficiency to have all to its (Power). AIl withdraw from the case or lose the case of visiting and has not all done ITT (Intention-To-Treat) France analyses. Testing statistical analysis after no document describes that has gone on (Statistical analysis that has not planned to be carried on in advance)In all bad incidents and response reports are analysed; The hopeless majority does not all have report, 114 altogether; The symptom and example that have only noted down the bad incident of every group are counted, but has not examined statistics, amounts to 48; The symptom and example of noting down the bad incident of every group are counted, and examine statistics under the circumstances that the example counts the circumstances of allowing, but the difference mentions the ModelⅡmistake while having no dominance; Only there are 6 to accord with this condition; Other bad to mention the bad incident, there are 15.2. Meta is analysedIn selected in 183ing, there are the treatment way to contrast groups in treating the group; Documents find that there are 11 that manage in doctors of traditional Chinese medicine through reading; But manage the law, or Western medicine treatment outside while comparing treating the group to assess Chinese medicine in it; Because does not manage in order to assess mainly with traditional Chinese medicine, so get rid of. Have 172 left adopt simple Western medicine manage do to have 57, simple traditional Chinese medicine do contrast have 11, other for contrast of mixing etc. contrast. 172 are in Jadad scale grade; 0-3 points can be regarded as 172 in low quality, there are no high-quality documents. It is analysed that it contrasted the group there were more than 2 ones that contrasted the way the samely and is 45 and selected. Among them there are 5 traditional Chinese medicine contrast; Include medicine made of two or more ingredients pearl dark sore slice have 3, bitter to join pill there are 2 Chinese herbs, Western medicine.Do heterogeneity inspection first; Except that the traditional Chinese medicine (contrasts the tetracycline) Treat the document data heterogeneity inspection P＜0.01 of the ache, show that there is obvious heterogeneity, should adopt the random effect model. Other group data heterogeneity of document inspection all P＞0.05, have obvious heterogeneity, should adopt the regular effect model to carry on Meta analysis.It all verifies traditional Chinese medicine to contrasting group's curative effect well to enter 10 groups of results that M eta analyses. The sensitiveness between the different models of needle is analysed, no matter between the regular effect model and random effect model, Meta analysis result between different designing quality shows, the difference between two models is very small, can prove the result that this Meta analyses is more steady. And then make the funnel picture; Is it draw to come with 5 more than document, result show 4 curative effect difference that Meta analyse and research to pour funnel picture have certain unsymmetry, so these are included in documents studied partial that certain issuing may exist ed.Conclusion1. It shows that documents study the analysis results of quality, Chinese medicine or the midwest cure the acne of treating and contrast clinically in the research document report at present, there are a lot of questions. Display the application studying about the epidemiology method to pay little attention to mainly, clinical testing is regulatory and relatively bad, it is difficult for the conclusion of clinical research to be generally acknowledged.2. Meta analysis results indicate, Chinese medicine or the therapy of combining traditional Chinese and Western medicine acne effective, his curative effect is superior to antibiotic pharmaceutical, vitamin A sour serial medicines. Have very good research prospects to may say Chinese medicine or therapy of combining traditional Chinese and Western medicine ache and disease.
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