| Purpose:To make the system analysis of the literature quality about treating RRTI in onoacute stage and the curative effect and the regularity of syndrom and medicine so that clinical treating decision can be made based on objective , believable evaluation of the treatment to RRTI by this method, to find out the problems in the study and provide the evidence for ulterior study strategy.Method: All the articles about the research work of treating RRTI in unacute stage from 1994 to Feb. 2006 were searched based on the methods of Evidence -based Medicine (EBM).Allthe articles were evaluated based on reliability classification, concealment of research allocation and JADAD standard, The articles consistent with Int standard were involved to analyze with META -analysis using Revman 4.2 sofeware. The scientific research design proposal , sample size, diagnostic criteria , differentiation of symptoms and signs criteria , curative effect criteria, statistical methods and effective power were summarized with descriptive statistics method. The type of syndrome, the recipe total count,medicine total count, medicine utilization frequency and medicine categorization were analyzed with frequence distribution method. Result: 84 articles met the criteria of quality evaluation , all of them is 0~1 in JADAD measuring scale and D glass in clinic random allocation concealment. The sample size of 42 articles is 101~200, The sample size of 4 articles is201~300, The sample size of 2 articles is over 300 , 80 studies mentioned diagnosis criteria , 4 studies mentioned not only Int criteria but also depl criteria , None of them mentioned the correct random allocation .44 articles compared the basic condition between two groups and specifically mentioned the comparability . None of them is double-blind trail ,1 study mentioned single blind method , but didn't describe wether or not test theblind measure .All of their curative effect evaluation criterions are self- formulate , 11 of them mentioned the reference of criterion .None of them mentioned wether detect the compliance of objects. Drop - outs were described in 1 cases . Follow - ups were described in 58 cases with concrete data. 4 studies mentioned safe detection ,9 studies specifically mentioned that there weren' t adverse effects, 3 studies mentioned the adverse effects. 74 studies applied statisticical method , 19 of them mentioned not only concrete statistic but also ambit P, 68 of them have the statisticical significance . The 54 articles consistent with Int standard were involved to analyze with META - analysis, OR is 5. 95 , confidence interval of 95% is [5. 07, 6. 89], Z=21. 76, P<0. 00001, The curative effect of HG is better than CG , and the difference between the two groups is significant.11 studies were involved in differentiation of symptoms and signs treating of TCM , The 4 most frenquent pattern of syndromes were asthenia of pulmonosplenic qi(649 persons) .insufficiency of lung - Qi(159 persons), pulmonasthenia (88 persons) ,deficiengcy of both vital energy and yin of pulmonosplenic (73 persons)by turns.103 studies were involved in basic recipe treating of TCM, The arch-treating methods were reinforce the lung and invigorate the spleen (3936 persons), reinforce lung , spleen and kidney (1917 persons),supplementing qi and nourishing yin (1013 persons) by turns . subsidiary-treating methods were removing food retention (1585 persons), activating blood circulation to dissipate blood stasis (463 persons), clearing away heat evil and promoting diuresis(418 persons), disperse the depressed liver-energy(463 persons), relieving shaoyang disorde(133 persons), eliminating wind and dissipate phlegm(141 persons).The frequency of applying astragali is 91, atractylodes macrocephalaj is 78, ledebourellae, radix is 71, hoelen is 36 , Codonopsis pilosula is 31, Glycyrrhiza uralensis js 31. The corresp applying frequency of medicine for reinforcing deficiency is 54.3%, medicine for relieving exterior syndrom is 12. 6%, heat-clearing medicine is 4. 5%.Conclusion:The quality of the literatures about TCM in treating RRTI in unacute stage is not good, The curative effect of TCM in treating RRTI in unacute stage is better than Western medicine P<0. 00001. The 4 most arch-pattern of syndromewere were asthenia of pulmonosplenic qi, def iciengcy of lung , spleen and kidney, deficiengcy of both vital energy and yin , insufficiency of lung - Qi by turns. The 4 most accompanied symptoms and signs were dyspeptic retention, blood stasis, humid heat, stagnation of liver-QI, Frequently used TCM were astragali, atractylodes macrocephalaj, ledebourellae, radix, hoelen, Codonopsis, Glycyrrhiza uralensis, heterophylly falsestarwort root, Chinese yam, orange peel, corium stomachium galli, Chinese jujube. The applying frequency of medicine for reinforcing deficiency is the most. The most applying prescription is Jade Screen Powder plus minus... |
PDF Full Text Request