Acupoint Application Combined With Huangqi Jianzhong Decoction In The Treatment Of Chronic Gastritis Of Spleen And Stomach Deficiency-cold Type:A Meta Analysis

Objective:Meta-analysis is used to systemly evaluate the clinical efficacy and safety of acupoint application combined with Huangqi Jianzhong decoction in treating chronic gastritis of spleen and stomach deficiency-cold type to provide evidence for clinical application of this method.Methods:According to the rules of meta,the standards of literature inclusion and the strategies of literature retrieval are established.We searched seven medical databases at home and abroad,such as CNKI,Wan Fang,and PubMed,from establishment of the databases to December 31,2021,about the treatment of chronic gastritis of spleen and stomach deficiency-cold type by acupoint application combined with Huangqi Jianzhong Decoction.The retrieved papers are imported into Note Express by scanning abstracts and reading the full text and the screening conditions are as following.(1)The study object in the literature is the chronic gastritis patients of spleen and stomach deficiency-cold type.(2)The study object in the literature is the chronic gastritis patients of spleenand stomach deficiency-cold type.(3)The treatment group is treated with acupoint application combined with Huangqi Jianzhong decoction or acupoint application combined with Huangqi Jianzhong decoction plus western medicines in control group.(4)The control group is treated with the conventional western medicines.The literature also contain one of the following outcome indicators: clinical efficiency,the scores of the traditional Chinese medicine symptoms(including stomachache,loss of appetite,nausea and vomiting,epigastric discomfort),Hp negative conversion rate,recurrence rate and adverse reactions.Finally,literature evaluation and data extraction are carried out for the papers included in RCT.The data are analyzed using StataSE 16 and Revman 5.4.Results:A total of 40 articles are included in this study.In the literature,29 cases are treated with acupoint application combined with Huangqi Jianzhong decoction vs conventional western medicines,11 cases are acupoint application combined with Huangqi Jianzhong decoction plus conventional western medicines vs conventional western medicines.Total 3,628 patients are inculded.There are both 1814 cases in the test group and the control group.(1)Acupoint application combined with Huangqi Jianzhong decoction vs western medicines alone:(1)Clinical efficiency: The total effective rate of acupoint application combined with Huangqi Jianzhong decoction is better than that of conventional western medicines [RR=1.27,95%CI(1.22,1.31),P< 0.00001];(2)The score of traditional Chinese medicine symptoms: acupoint application combined with Huangqi Jianzhong decoction ismore effective than western medicines in improving patients’ symptoms: stomachache:SMD=-3.08,95%CI(-4.07,-2.10),P< 0.00001,loss of appetite symptoms: SM D=-6.24,95%CI(-9.26,-3.21),P < 0.0001,nausea vomiting symptoms:SMD=-4.08,95%CI(-5.51,-2.65),P < 0.00001,epigastric discomfort symptoms:SMD=-4.41,95%CI(-6.12,-2.70),P< 0.00001;(3)Hp negative conversion rate: Hp negative conversion rate using acupoint application combined with Huangqi Jianzhong decoction is higher than western medicines alone[RR=1.51,95%CI(1.25,1.83),P < 0.0001];(4)Recurrence rate: Generally,the recurrence rate of acupoint application combined with Huangqi Jianzhong decoction is lower than western medicines alone[RR=0.14,95%CI(0.07,0.30),P< 0.00001].(2)Acupoint application combined with Huangqi Jianzhong Decoction plus western medicines vs western medicines:(1)Clinical efficiency: acupoint application combined with Huangqi Jianzhong decoction combined with western medicines has better curative effect than western medicines alone[RR=1.19,95%CI(1.14,1.25),P< 0.00001];(2)The scores of traditional Chinese medicine symptoms comparsion;acupoint application combined with Huangqi Jianzhong decoction is more effective than western medicines alone in improving patients’ symptoms: stomachache:SMD=-3.50,95%CI(-5.29,-1.71),P=0.0001< 0.05,epigastric discomfort symptoms: SMD=-2.59,95%CI(-4.25,-0.92),P=0.002< 0.05,nausea vomiting symptoms: SMD=-2.43,95%CI(-3.45,-1.41),P < 0.0001;(3)Hp negative conversion rate symptoms: The eradication effect of Hp by acupoint application combinedwith Huangqi Jianzhong decoction combined with conventionalwestern medicine is higher than western medicines alone[RR=1.46,95%CI(1.27,1.68),P< 0.00001].(3)Security analysis: The occurrence of adverse reactions after acupoint application combined with Huangqi Jianzhong decoction is lower than that of western medicines alone,and the safety is better[RR=0.28,95%CI(0.16,0.51),P < 0.0001].The adverse reactions of acupoint application plus Huangqi Jianzhong decoction combined with western medicine is similar with western medicines alone.The difference is not statistically significant[RR=1.49,95%CI(1.00,2.20),P=0.05].Conclusion:1.Acupoint application combined with Huangqi Jianzhong Decoction,acupoint application combined with Huangqi Jianzhong Decoction and western medicine in the control group have more advantages in improving the comprehensive curative effect of chronic gastritis patients with spleen-stomach deficiency-cold type,increasing the negative rate of Hp,and improving the TCM symptoms of stomachache,inappetence,nausea and vomiting,and epigastric discomfort.2.Compared with conventional western medicine,the recurrence rate and adverse reaction rate of acupoint application combined with Huangqi Jianzhong Decoction are lower,but the adverse reaction rate of western medicine in the control group of acupoint application combined with Huangqi Jianzhong Decoction is similar to that of western medicine alone.