Chinese Medicine Literature Evaluation Of Treatment Of Herpes Zoster

ObjectiveBelt-shaped blister measles(herpeszoster) is the acute inflammation skin disease which causes by the chicken pox - belt-shaped blister measles virus,its main characteristic for the bunch of collection blister,the peripheral nerve makes the aggregated belt-shaped distribution along one side,is accompanied by the obvious neuralgia.The belt-shaped blister measles Chinese medicine called"can yao huo dan","she dan","zhi zhu chuang" and so on.The Chinese medicine or treatment internal medicine external use, the acupuncture and moxibustion,the cupping,the thorn wind as well as Chinese medicine modernization preparation and so on,all take its accurate clinical curative effects and the low poisonous side effect,and after that lost neuralgia as the treatment belt-shaped blister measles the solution to provide the beneficial reference.Chinese medicine therapy treating belt-shaped blister measles have own characteristic,in particular loses neuralgia aspect after the belt-shaped blister measles,on the clinical such report are more and more;It is noteworthy that these research existence flaw, mainly is the clinical curative effect judgment standard that is not unified, the scientific research design insufficiently is rigorous,lacks carries on the stochastic blind method comparison observation,the statistical method flaw.This research mainly uses the system appraisal and the Meta analysis method to comprehensively understanding Chinese medicine clinical scientific research methodology application condition of belt-shaped blister measles,the existence question,appraised objectively the research quality of the aggregate level,the science appraisal of Chinese medicine and the cooperation of Chinese and Western medicine treatment validity and the security,will provide the clue and the mentality for the next research.MethodIntegrates the China biomedicine literature compact disc database(the CBM,1998-2008 year) and(the CNKI,1998-2008 year) treating the belt-shaped blister measles with the Chinese periodical full text database and after that loses neuralgia the literature,followed the basis clinical epidemiology /DME methodology principle and the method,according to《Chinese medicine Medical Literature System Appraisal Work Handbook》the standard,formulates《Chinese medicine Treatment Belt-shaped Blister Measles Literature System Appraisal And Information Gathering Table》.Randomizedly selects 30 literature to carry on stochastically by two researchers having graduate student Ievel initially comments,after 2 weeks to carry on the appraisal again to the same literature,then《Appraisal Table》carries on the uniform examination to 30,confirmed has the good reliability(the Kappa value is 0.80).To tallies integrates the standard literature to carry on the appraisal.The appraisal content divides into 4 major parts:Literature ordinary circumstances,experiment project design,statistical method utilization and conclusion inferential reasoning.Under the partial clauses is equipped with the child clause,the content involves the clinical scientific research design the main principle and the belt-shaped blister measles disease characteristic.The concrete content includes:Ordinary circumstances: Literature author,source,publication age limit and so on;Experimental plan design:Case of illness originates,the sample content,disease diagnosis and integrates,the elimination standard,the comparison situation,the group the equalization and comparison medicine service condition, randomisation method,blind method the utilization,the intervention measure and the medication situation,the curative effect determination standard; Findings statistical analysis:The statistical method description and the utilization,withdraw with lose visit the record and the analysis which case of illness the analysis,responded not good.The Meta analysis literature was 1989 - 2008 publishes in domestic medicine core periodical Chinese medicine treatment belt-shaped blister measles and after that loses neuralgia the stochastic comparison clinical research literature.When the test result has not appeared the non-uniformity (P＞0.05),then uses the fixed effect model(fixed effects model),otherwise uses the random effect model(random effects model).If has the non-uniformity (P＜0.05),then will have the same design proposal,the research quality, the publication year and so on forms a group,will carry on the subunit analysis;If subunit analysis demonstration non-uniformity,then gives up the Meta analysis,only makes the statistical description.Carries on the publication dominance using the Revman4.2 manufacture funnel chart the examination.By Meta analysis result in sign stderr(score compared to the OR logarithm) took by mistake the Y axis,by OR(treatment group effective population/control group effective population) took X axis,draws the funnel chart,analyzes clinical research material distributed shape which collects, judges whether has the publication dominance,integrates the literature number is bigger than 5 pieces to conduct the publication dominance research (inspection levelα=0.05).The goal mainly is the appraisal belt-shaped blister measles acute outbreak and latter loses neuralgia Chinese medicine treatment and the western medicine treatment to the curative effect the influence,therefore between the rejection Chinese medicine pharmacotherapy compares literature.We selected according to the request carries on the Meta analysis the literature is initially 52.According to the method of treatment difference,carries on the analysis according to under several aspects:The Chinese medicine takes orally vs western medicine treatment belt-shaped blister measles acute outbreak,after the Chinese medicine takes orally vs western medicine treatment belt-shaped blister measles to lose neuralgia,the Chinese medicine external use vs western medicine treatment belt-shaped blister measles acute outbreak,the Chinese medicine internal medicine external use vs western medicine treatment belt-shaped blister measles acute outbreak,after Chinese medicine internal medicine +western medicine vs western medicine treatment belt-shaped blister measles loses neuralgia,the Chinese medicine internal medicine + physical therapy vs western medicine treatment belt-shaped blister measles acute outbreak,the Chinese medicine external use + western medicine vs western medicine treatment belt-shaped blister measles acute outbreak,the acupuncture primarily vs western medicine treatment belt-shaped blister measles acute outbreak,after acupuncture primarily vs western medicine treatment belt-shaped blister measles loses neuralgia.ResultAltogether picks out belt-shaped blister measles Chinese medical literature 279 through two databases,RCT literature 76,occupy the complete literature 27.60%.According to follows the card medical literature evidence graduation to achieve two levels of above literature probably occupy 1/3, the overall follow the card rank not to be high.According to improves the JADAD grading demonstration stochastic check experiment the research quality not to be high,all for low quality research,does not have a high grade stochastic double blind research.The majority of literature use standard decided by oneself,the explicit explanation uses the state-level,in the bureau level perhaps the textbook standard has 28,according to the literature judgment,majority of standard decided by oneself and the authoritative standard basic consistent;Above result showed the researcher does not take the research regulated standard, possibly can affect the Chinese medicine curative effect judgment accuracy and the research conclusion extrapolation.This studies in 76 literature,a literature not to mention in anticipation sample content the estimate,this directly will affect the research conclusion the accuracy and the reliability.Only the minority literature draws lots the random distribution treatment group according to the successively order and the control group,this research only has 1 literature to use single blind method,ln 76 literature mentioned explicitly the group the balanced literature has 36,explained the majority of researchers take the group balanced the findings influence.The treatment group's intervention measure,the Chinese medicine internal medicine,external use, the acupuncture use proportion is highest,this the belt-shaped blister measles morbidity characteristic is related,the acute stage common Chinese medicine internal medicine external use,is generally the refrigeration disintoxicating Chinese medicine;The chronic general outside governs, mainly is the acupuncture and moxibustion,physical therapy ways and so on cupping glass and god lamp.Control group's intervention measure mainly is the anti-viral western medicine western medicine oral administration,or few literature introduction immunity conditioner injection and so on.In the intervention measure standardization and the stable aspect,the control group does well,the treatment group few parts are not very stable,the treatment time comparison at will,the obvious Chinese medicine pharmacotherapy standardization and the stable pending enhances,in particular the Chinese medicine decoction treatment,how solves the stability which the medicine originates,the decoction method,takes the method the uniformity,the decoction along with the card addition and subtraction medicine to the result influence and so on,all is the question which solves with difficulty.The integrates the research in the literature,some 14(accounted for 18.42%) the literature specify curative effect determination target statistics analysis method.Some 20 literature give the P value merely the scope or the statistics,also has not carried on the explanation to its application statistical method,determines its findings with difficulty. Method computation Chinese medicine intervention measure relative western medicine effect criterion analyzes which with Meta---Superiority ratio. Different carries on the analysis separately according to the intervention measure;After the non-uniformity examination,discovered the majority of object of study homogeneity,finally demonstrated,after the Chinese medicine internal medicine treatment belt-shaped blister measles acute outbreak and latter loses neuralgia,the Chinese medicine external use treatment belt-shaped blister measles acute outbreak,the Chinese medicine external use treatment belt-shaped blister measles acute outbreak,the acupuncture primarily treats the belt-shaped blister measles acute outbreak, the acupuncture primarily treats the belt-shaped blister measles to lose neuralgia superiority compared to be located in 95%credible sector, explained above Chinese medicine remedial measure the influence has statistics significance to the curative effect,provides the basis for the Chinese medicine treatment belt-shaped blister measles.At the same time, the block the result is consistent,explained this findings credible also the authenticity is high.Moreover as a result of the literature reason,after the Chinese medicine internal medicine external use treatment belt-shaped blister measles acute outbreak,Chinese medicine internal medicine + western medicine treatment belt-shaped blister measles lost neuralgia,the Chinese medicine internal medicine + physical therapy treatment belt-shaped blister measles acute outbreak curative effect still cannot appraise.ConclusionIt is certain curative effect after the Meta analysis demonstration Chinese medicine treatment belt-shaped blister measles,in the application which provides medicine evidence for the Chinese medicine pharmacotherapy, but pay attention to the above conclusion and the experimental methodology quality.The literature quality appraisal prompt that the Chinese medicine treatment belt-shaped blister measles research literature has certain enhancement in clinical scientific research design aspect oneself, stochastic and the comparison concept,the statistical method has been accepted gradually by the researcher.But possiblely because the Chinese medicine clinical scientific research level limit formerly and the Chinese medicine theory in the objectification,the standardized aspect study insufficiency,clinical test methodology quality should be enhancement.