| BackgroundFunctional Dyspepsia (Functional Dyspepsia, FD) is a dysfunction of the stomach and duodenum causing symptoms, on checking out the cause of these symptoms of organic disease clinical syndrome, a group of main symptoms include abdominal pain, epigastric burning, full after meals, and early full [1], in accordance with the Rome III norm on abdominal pain syndrome (epigastric pain syndrome, EPS) and postprandial discomfort syndrome (postprandial distress syndrome, PDS). Functional dyspepsia is a clinical common disease, clinical, already a lot of indigestion of the patient in the hospital after endoscopic examination, the result is expressed as the chronic superficial gastritis in the very great degree are functional dyspepsia. As early as ten years ago, in Guangzhou a epidemiological studies have shown that 23.5% of respondents with FD symptoms, in Europe a epidemiological study found that 20.6% of respondents in nearly a year have abdominal discomfort symptoms.Now, with the change of living environment, the incidence of the disease showing a rising trend, and the disease symptoms, duration long, over and over again, to the patient’s quality of life and health of body and mind are caused adverse effect.Functional dyspepsia is currently there is no cure. Patients with functional dyspepsia treatment goals to ease the diagnosis with discomfort, nausea, belching and inappetence, improve patient quality of life. In terms of treatment, mainly adopts drug treatment. Drugs can relieve clinical symptoms, to some extent control the disease development, but because of the medication for a long time, the patient’s compliance often over time is reduced, and patients with long-term treatment also easy to bring the huge spirit and economic pressure. Western medicine treatment of this disease so far no major breakthrough. Main drug for xisha, Billy and promote gastrointestinal medicine and symptomatic treatment, but the effect is not satisfactory, and there are certain side effects. Traditional Chinese medicine in the treatment of the disease for a long time of practice, accumulated a lot of experience and effective agent, treatment is diversiform, curative effect affirmation, and can be carried out according to the difference of individual patients themselves, making has a huge advantage. In recent years, many scholars [6] the Chinese medicine treatment, the preliminary evidence that Chinese medicine treatment of FD has certain advantages, and some achievements have been achieved.In recent years, more and more clinicalt studies used randomized controlled methods of observation, research, and compared the clinical effect of traditional Chinese medicine in the treatment of functional dyspepsia, and published a large number of literature, but the current evaluation system of therapeutic literature evaluation. In the case of lack of large-scale randomized controlled clinical research, the deijhvelopment of evihhdence-bagsed medihhgcine to clgjinical debate prodvides a giood wday to resolve this problem, through the system and comprehensive collecftion aldl ovefr thfe wodrlde begen publgisfhed and unpublished clinical research results, using principles and methods of clinical epidemiology strict evaluation literature, selected conforms to the quality standard of literature, qualitative or quantitative synthesis, comprehensive and reliable conclusion. Meta analysis of the related research of evidence-based medicine (ebm) has been in the treatment, prevention, causes, harm, prognosis, diagnosis, on applying economic analysis, and other fields, because of the systematic review or meta-analysis of highest reliability, located at the state university of New York Downstate Medical Center to launch the top of the pyramid "evidence". The purpose of this study is to apply the system evaluation method, evaluation of traditional Chinese medicine therapy, such as medicine or traditional Chinese acupuncture and massage on the curative effect of the disease, provide a reference for application of Chinese medicine in treatment of functional dyspepsia.ObjectiveBased on the traditional Chinese medicine in the treatment of functional dyspepsia clinical trials literature study, in order to achieve the following objectives:(1) system to evaluate the effect of traditional Chinese medicine in the treatment of functional dyspepsia and security; (2) more than 50 years of traditional Chinese medicine in the treatment of functional dyspepsia random or stochastic, and clinical reports the number of cases is greater than the treatment of 20 cases of literature, establish a database, for the clinical dialectical treats the disease and the regularity of TCM drugs to provide the reference. (3) evaluation system compared with western medicine and placebo, whether traditional Chinese medicine in the treatment of functional dyspepsia has obvious advantages.MethodsComputer retrieval Chinese biomedical literature database; Tsinghua tongfang series database (CNKI) of China journal full-text database; Chinese science and technology periodical database; VIP information network; Ten thousand the database; PubMed medical literature retrieval service system; Coehrane library evaluation database and Coehrane Coehrane system in controlled trials core registration database and in the clinical trial report papers or tracking related literatures review of references. Retrieve the life have built from library until January 2015. Manual retrieval into the study of references and related magazines, conference proceedings, dissertation assembly, etc. Ask the author about whether there is a gray unpublished literature. By two researchers independently to meet eligibility criteria of randomized controlled trials and half a randomized controlled trial for quality evaluation and information extraction, and cross check. If there are any differences, through discussion or by third parties to talk things over solve. According to Cochrane screening tests of system evaluation method and evaluation of the quality, extracting information, and the Meta analysis RevMan 5.3 software. For binary classification variables, calculation of odds ratio (odds thewire, OR) and 95% confidence interval analysis results. For continuous variables, then calculate the weighted mean differences (weighted mean differenees, WMD) and 95% confidence interval "key words" functional dyspepsia "; " The doctor of traditional Chinese medicine, Chinese medicine or Chinese medicine; "Clinical, control" and other key words search, establish a database and analyzed. Evaluation of clinical symptoms include test only this system efficiently and the overall integration of TCM symptoms improved after treatment.ResultsAfter strict screening, assessment, and to discuss the (1) were included in the 10 randomized controlled trial,1104 patients, the treatment group 690 cases, control group 414 cases. Included in the methodological quality of trials was high (Jadad score 3 points or higher), according to the Cochrane collaboration bias risk evaluation criteria:10 article has A grade A, grade 9 B. Meda analdfafis or desdfadtive dgalysis afr extafafdting data. (1) 2-4 weeks after treatment the clinical symptoms of efficient:pure traditional Chinese medicine is superior to western medicine OR placebo [OR a value of 6.2,95% confidence interval [(3.45,3.45)], Z=7.28 (P<0.00001)],2-4 weeks after treatment the clinical symptoms of recovery rate:pure traditional Chinese medicine is superior to western medicine OR placebo [OR 2.48,95% confidence interal (1.73,1.73), Z=7.28 (P<0.00001), the TCM syndrome integral [WMD=3.23,95% CI (3.46,3.00), Z=27.12 (P<0.00001). But as a result of P<0.00001),12>50%, that is unfavorable use META analysis to evaluate the TCM symptom integral, has been changed to descriptive evaluation.(2)This study suggests that the inclusion of 10 randomized controlled comparison of functional dyspepsia medicine test, in terms of efficacy, TCM effective than western medicine, there are significant differences between the two groups; gastrointestinal symptom score improvements overall, compared with Chinese medicine Western medicine can better improve overall digestive tract in patients with functional dyspepsia symptom scores? in improving the gastrointestinal symptoms single integral aspect of Chinese medicine for epigastric fullness, heartburn, abdominal pain, nausea and vomiting effect is better than western medicine.ConclusionThe existing evidence suggests that the curative effect of traditional Chinese medicine in the treatment of functional dyspepsia is western medicine such as much Pan Li ketone, sand Billy, compared curative effect is obvious, has the potential replication. But due to the into clinical outcome evaluation index and the number and quality of literature, the effect of TCM on functional dyspepsia and the advantage of safety must be more clinical trials to test in order to have a high quality of randomized controlled trials to confirm the exact efficacy of traditional Chinese medicine in the treatment of functional dyspepsia. |
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