| ObjectiveChronic gastritis, chronic gastritis, CG) is the most common diseases and frequently-occurring disease, digestive system according to the clinical symptoms were divided into chronic atrophic gastritis, chronic atrophic and other special type. The incidence of chronic gastritis with very high, the highest in the digestive system disease, more than accounted for about 80% of the patients with gastroscopy. Chronic gastritis in lack of very unique clinical performance, roughly 50% of the patients will appear on the abdominal discomfort, postprandial full bilge, diagnosis, and the corresponding reflection area ache, the diagnosis and the esophagus burning pain, so no obvious regularity, clinical presentation, and pain, and can show correlation or no correlation, if the general clinical symptoms after eating have increased. Can also with some other digestive tract and digestive symptoms, such as loss of appetite, acid regurgitation nausea, frequent gas, can some patients without clinical symptoms. For the cause of chronic gastritis, western medicine more recognized factors include h. pylori (Helicobacter pylori, Hp), bile reflux, bile regurgitation, BR), immune mechanism and genetic factors, physical factors and other factors such as in the treatment of western medicine’s main goal is to improve the patient’s clinical symptom such as indigestion and pain and regulating the stomach mucosa inflammatory reaction; Western medicine in the treatment of western medicine at present so want to be able to in view of the causes, take according to the principle of individual different etiological treatment. For some guide Suggestions need Hp eradication of patients, such as chronic atrophic gastritis, gastric mucosa atrophy, gastric mucosal erosion or those with a family history of gastric cancer patients, emphatically recommended the eradication of Hp. Is negative for HP gastric mucosa erosion, other symptoms such as acid reflux, upper abdominal pain and other symptoms of patients, according to the patient, compliance, and digestive tract symptom severity the choice of appropriate drugs and hydrochloric acid in gastric juice, such as acid inhibitors, proton pump inhibitors (PPI) and H2 receptor antagonist. And may, according to patients with symptoms of indigestion, stomach power fades as appropriate chooses to promote gastrointestinal medicine (such as sand Billy, etc), digestive enzyme preparations, etc. The doctor of traditional Chinese medicine treatment of chronic gastritis on the basis of syndrome differentiation and subtract, can obtain satisfactory clinical effect. In this long medicine of traditional Chinese medicine system, according to traditional theory, chronic gastritis according to its clinical manifestations, symptoms and signs, can be classified as the diagnosis the new full, acid and stomach category, while the acknowledgement for the present the analysis of the clinical syndromes of chronic gastritis is varied, this study is common to qi deficiency of spleen and stomach type as the main research object, on the basis of literature research, medicinal broth of traditional Chinese medicines on the spleen and replenishing qi treatment of chronic gastritis system to assess the efficacy and safety of; Understand the treatment current situation, the analysis method of spleen yiqi characteristic function and efficacy of the treatment of chronic gastritis, to the spleen yiqi method provide certain evidence of evidence-based medicine for the treatment of chronic gastritis, chronic gastritis is clinical research and application to provide more reference.MethodsThe design of this article research altogether is divided into three parts, respectively is the traditional Chinese and western literature research, systems evaluation and clinical research.System evaluation:the object of study, published in domestic the spleen and replenishing qi method for the treatment of chronic gastritis clinical curative effect of randomized controlled documents. Literature sources: (CBM), (CNKI), (VIP) and wanfang data knowledge service platform, as well as PubMed database, at the same time, manual retrieval magazine specialized information (start of the database for the 1999-2014) inclusion criteria:(1) the type of clinical randomized controlled trials (RCT), whether or not use the blind method; (2) the main interventions for spleen yiqi method is given priority to the treatment of chronic gastritis, the control group to use pure western medicine treatment of chronic gastritis; 3. Good balance between the groups; (4) there is a clear agreement of curative effect evaluation standard. Exclusion criteria:(1) the control for the pure western medicine treatment of other clinical trials, such as placebo-controlled) (clinical impossible, combine traditional Chinese and western medicine control, or other types of traditional Chinese medicine or proprietary Chinese medicine control; (2) the curative effect evaluation is not standard or not detailed treatment as a result, there is no statistics of basic data needed for clinical trials; (3) design of experiments have obvious errors or defects. For eligible quality of literature evaluation using the Jadad score method:(1) whether patients with real randomly assigned to treatment group or control group, and ensure the observer and patients don’t know what will a set before allocation (random points 2 points,2=right description of the random method; 1= author described as random); (2) whether in addition to the intervention study, the other two groups in treating; (3) whether the blind method (blinded score 0 to 2 points, 2 points= patients and subjects double-blind, are described and its methods, 1= the narrative as a double blind; 0= not blinded); (4) the existence of bias, namely exit test of whether there is a system similar between the two groups (whether is lost to follow-up and lost to the cause of the 0-1); RCT total score of 1 to 5 points, three points for the research of high quality, 1 and 2 are divided into low quality research. The meta-analysis of the literature of eventually meet, evaluate its efficacy and safety. Clinical research:Research objects are derived from the second affiliated hospital of guangzhou university of TCM (guangdong province hospital) digestive specialist outpatient and hospitalized patients. Case collection time for May 2014 February 2015.Inclusion criteria:in line with the diagnostic criteria of traditional Chinese medicine (TCM) and western medicine to standard syndromes; Ranging in age from 18 to 70 years old; Willing to work with patients for the treatment of observation. Exclusion criteria:with severe cardiovascular, liver, kidney and hematopoietic system disease and mental patient, confirmed by radiological patients with digestive tract tumor and ulcer perforation;Pregnancy or lactation women;Don’t want to cooperate with treatment of observer. For traditional Chinese medicine in patients with into standard amomum 6 gentleman tonga subtraction method (by dangshen, baizhu, fuling, pinellia, chenpi, radix aucklandiae, amomum villosum, main licorice etc) oral, water decoction, a dose of therapy for four weeks. Can cooperate with characteristics of external treatment of traditional Chinese medicine. Of main symptoms after treatment (early satiation, epigastric pain, after full bilge) score, for other symptoms using nim horizon method, curative effect index= (before points points after treatment) before/treatment of integral evaluation of TCM syndrome x 100% change.ResultDetection system evaluation:a total of spleen and replenishing qi therapy for the treatment of chronic gastritis related with 370 references,75 citations to eliminate repetition apparently irrelevant literature by reading articles, excluded, download to read the full article, eliminate the random controlled study, eventually into 20 references. Bias risk assessment showed that the quality of the into the literature methodology and reporting quality is generally low, with high risk of bias. The quality of literature evaluation of the literature of into 20,20 articles were the communist party of China (the experimental group 1263 cases, control group 1208 cases,20 articles are based on a single-center study,0 for center study; 20 studies and research are not strictly randomized controlled trials only 2 paper describing specific randomized method (with random number table method randomized), the other articles are only adopted random methods mentioned. Article 20 are not blind method literature research, made no mention of random scheme to hide. In addition, there is no clinical trials report sample size calculation or report using analysis; Six research papers on some replacement of drug adverse reactions; There are 5 articles on exit and lost to follow-up cases but to the exit and lost to follow-up cases are not described in detail, no intentional analysis.20 in the paper the jadad score only 2 to 3 points, the rest 18 articles were jadad scoring only two points, the overall quality of literature on the low side,20 and funnel chart suggests that literature research may be published sexual bias, results of Meta analysis comparing the total effective rate, one by one, the results of research to exclude a Meta analysis compared with the results of the former has not been ruled out, there was no significant difference, that the spleen yiqi method for the treatment of chronic gastritis of Meta analysis result is stable and reliable.Clinical research:in the spleen and stomach qi deficiency of chronic gastritis patients received a total of four weeks after amomum 6 gentleman decoction of traditional Chinese medicines, compare the main symptoms (after the meal full bilge unwell, earlier satiation, upper abdominal pain) evaluation: after treatment compared with before treatment, patients with three major symptoms were improved, which after a meal full bilge unwell healed in 11 cases, 35 cases were markedly improved, the total effective rate was 59.74% 14 cases early full recovery,26 cases were markedly effective, total effective rate 51.95%, abdominal pain recovery on 21 cases,24 cases were markedly effective, total effective rate was 58.44%; Symptom score eight aspects, and are better, symptoms total effective rate calculated by nim horizon method reached 96.1%; Results show that the aromatic type sand 6 gentleman decoction on spleen deficiency of chronic gastritis patients with clinical symptoms and symptoms improved significantly.ConelusionSystem evaluation:spleen yiqi method of traditional Chinese medicine treatment of ovulation disorder infertility is a kind of effective method, but there are still many shortcomings:(1) in the clinical trials literature quality is low, (2) about the curative effect and diagnosis standard, reduce the results of the study of persuasion and scientific; (3) random method is incomplete; (4) no use the blind method; (5) the lack of adverse reactions of record; 6. The lack of records lost to follow-up. For the long-term curative effect is unable to make a scientific evaluation, so as to reduce the credibility of the clinical curative effect; All landowners published sex bias. So after need to confirmed by high quality randomized controlled multicenter trial of and review.Clinical research:the study looked at 77 patients, after cure tip:after 4 weeks therapy in patients with main symptoms (after the meal full bilge unwell, earlier satiation,upper abdominal pain) score has obvious improvement than before treatment, recovery and the number of cases were markedly improved calculating total effective rate is over 50%, symptoms symptoms integral in the diagnosis the new full, postprandial abdominal distension, pain diagnosis, poor appetite, mental fatigue, thin limbs not lukewarm, defecate pond in seven aspects, such as before the treatment have different degrees of improvement, according to nim horizon method to calculate the total effective rate up to 96.1%. Indicates amomum 6 gentleman decoction on spleen and stomach qi deficiency of chronic gastritis with good curative effect. |
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