A Systematic Review Of Traditional Chinese Medicine Syndrome And Treatment Of Peptic Ulcer And Its Clinical Efficacy

Purpose:In order to provide reference to clinical experience and scientific research, and reflect advantages of Traditional Chinese Medicine (TCM) in peptic ulcer (PU), this article conclude the differentiation-prescription rules of PU by a retrospective analysis of clinical data of PU;In order to spread clinical experience and academic thoughts of professor Zhou Xuewen,through summarized the rules of prescriptions to treat PU;analyzed the methodology for quality , curative effect and clinical security about literature of oral traditional chinese medicine randomized controlled trials (RCT) in PU,and valuate objectively the advantages and disadvantages of TCM in the treatment of peptic ulcer, so as to provide evidence of evidence-based medicine(EBM)Material and method:1.To get the catalog of the documents through China biomedical(CBM) literature database by using peptic ulcer (PU)as key words for subject access select weighted, all trees, all sub-themes to extend search. Then access to bibliography by the Chinese Academic Journal (CNKI) ,VIP Full-text databases,( VIP), WANFANG Database to obtain the original documents in Chinese,Have a metrological analysis with the literature that meet the requirements of document class name of syndrome the number of cases drugs used2. Entering the clinical data of the 115 example of the active stage peptic ulcer patients. Concluded the character of the disease symptom and the knowledge of the treatment and laws of using drugs by using the methods of frequency analysis and the associated rules method of analysis.3.Through collecting standard chinese medicine treatment of peptic ulcer R randomized controlled trials. In accordance with the Handbook 5.0.2 System Evaluation GRADE standards .The methodology of the literature Quality of Literature Evaluation .The extracted meta-analysis of relevant data. Results:1. The research of PU through TCM treatmentIncorporate 1103 pieces of original artial, there were 168 pieces artia were about treatment according to syndrome differentiation and 935 were not, The drugs are more common in Licorice, white peony root, Baiji, cuttlefish bone, astragalus, Yuan Hu, Bai Zhu, berberine, Codonopsis, Dandelion, Panax, dried tangerine peel, red sage root, Poria, Bupleurum, Cyperus rotundus, Pinellia, Citrus aurantium, Amomum, Guizhi , Mu-xaing, etc . The names of the syndrome were miscellaneous, there were 128 types of name among in 168 pieces text that were about treatment according to syndrome differentiation. Through the classified summary there were spleen-stomach deficiency, certificates stomach heat flaming, blood stasis stagnation card, liver and stomach-Qi stagnation, stomach-yin deficiency, diet stagnation card, Han-xie off stomach card, hot and humid in the resistance card, phlegm block card, disharmony between liver and spleeen, cold and heat mixed card, with Qi-deficiency and blood -stasis , the others (spleen-stomach heat, cold and blood stasis, heat stasis stomac-luo, the actual situation inclusions, Bleeding), and other syndromes, and there were six types of syndrome were in common: spleen-stomach deficiency (32.04%), liver and stomach qi stagnation (24.67%), blood stasis stagnation card (12.14%), stomach-yin deficiency syndrome (8.46%), stomach heat flaming card (8.18%), hot and humid in the retention syndrome (5.85%).The prescription to treat the syndrome of spleen-stomach deficiency is Licorice, Astragalus, Atractylodes, white peony root, Codonopsis, cassia twig, dry ginger, etc., which is so called Liujunzi Tang, Huangqi-Jianzhong Tang, Li Zhong Tang and can be properly added with Baiji, Yuan Hu, cuttlefish bone, and other myogenic corrugated sub-acid, add villosum, Cyperus rotundus,mu-xiang and other regulating-qi drugs, Salvia, and notoginseng, berberine, dandelion and other heat; The prescription to treat the syndrome of liver and stomach qi stagnation is Licorice, Bupleurum, white peony root, Cyperus rotundus, Citrus aurantium, Citrus, cuttlefish bone, Yuan Hu, etc., which is so called ChaiHuShuGanSan, Jin Ling Zi Powder as the popular prescription, with panax blood Salvia, Scutellaria, etc. Coptis dandelion Heat, Astragalus, Atractylodes, Codonopsis other spleen, Baiji, cuttlefish bone, corrugated sub-acid and other myogenic; The prescription to treat the syndrome of blood stasis stagnation card is Licorice, Wulingzhi, Yuan Hu, SM, Baiji, Puhuang, Toosendan so, that Shixiaosan, Salvia drink, Jin Ling Zi Powder as the commonly used prescriptions. With notoginseng, red peony root, peach kernel, Chuanxiong, safflower and other blood circulation, Cyperus rotundus, aggregata, dried tangerine peel, etc. qi, Astragalus, Codonopsis, Atractylodes, Angelica and other nourishing Qi, berberine, and dandelion to clearing away heat and toxic material; The prescription to treat the syndrome of stomach yin deficiency is Radix, licorice root, Radix, white peony root, Dendrobium, Baiji, astragalus, habitat, Polygonatum and so on. That is, Yiwei Tang, wheat Asp soup, such as the commonly used SGD prescription, compatibility cuttlefish bone, corrugated sub-acid, Astragalus, Atractylodes, Codonopsis, angelica and other nourishing qi; The prescription to treat the syndrome of stomach heat flaming card is Berberine, dandelion, gardenia, peony tree bark, skullcap Qingrejiedu, Yuan Hu, Salvia, and notoginseng blood, Baiji, cuttlefish bone, corrugated sub-myogenic acid. Cyperus rotundus, Citrus aurantium, blue, etc. qi, Astragalus, Atractylodes spleen; The prescription to treat the syndrome of hot and humid in the retention is Coptis, Pinellia, Poria, skullcap, herb, dandelion Magnolia, gardenia, Coix seed and other heat dampness, Baiji cuttlefish bone, corrugated sub-acid and other myogenic, Codonopsis, Atractylodes, Astragalus spleen2. Professor Zhou Xuewen experience in treatment of peptic ulcer and Data MiningThe main clinical syndromes of the 115 PU patients are Epigastric pain, fullness, acid regurgitation, dry mouth, belching, heartburn, poor appetite, nausea, mouth pain, vomiting and the other syndromes are poor sleep, dry stool, abdominal pain, black stools, hiccups, irritability, loose stools, mouth stick, etc. Tongue to tongue is red, red purple is more common, tongue with yellow greasy fur product powder coating, corrosion coating, thin yellow fur common, pulse to pulse string, string taut slippery pulse and the pulse is more common, Endoscopic mucosal visible edema around the ulcer; the distribution stomach syndrome Abdominal most toxic heat syndrome and more (62%), followed by the syndrome of liver and stomach qi stagnation (15%), spleen and stomach deficiency card (11%), again blood stasis stagnation card, certificate of stomach yin deficiency, and the most rare spleen and stomach deficiency with cold (1%). Detoxification treatment to heat-based, with invigoratings Spleen Qi, myogenic convergence sores, su-gan, regulate qi (qi), blood circulation and so on. 147 treatment regimen, medication 91 flavor, commonly used drugs are Astragalus, Coptis, Baiji, Zhejiang Fritillaria, licorice root, Bupleurum, Sophora, dandelion, cuttlefish bone, Yuan Hu, Panax, blue, sage, golden bell son Duan corrugated, white cardamom, Salvia, Amomum. Compatibility with Coptis and Astragalus Common, Son, and Jin Ling Yuan Hu, and cuttlefish bone Fritillaria.3. The system evaluation of the treatment to PU by using TCMIncluded 13 randomized controlled trials (RCT), including 3036 cases of patients, sample size ranged from 72 to 494,the quality of all research methodological:?There are 3 case studies described concealment;?There are two studies have addressed the existence of cases during the study excluded lost, and exit,?all studies were not intentional analysis,?4 studies described the incidence of adverse reactions,?8 research institutes researchers with experience in testing drugs for the hospital or its agents,?study did not conduct clinical trials of all registered. The Quality of evidence: Evaluation of all research results are evidence of low quality or low quality. Meta analysis showed: endoscopic treatment of peptic ulcer cure and efficacy of traditional Chinese medicine effective symptom by some traditional Chinese medicine is better than ranitidine(P=0.002,P=0.0004), six months and one year recurrence rate of ulcers than ranitidine(P=0.004,P<0.0001);endoscopic treatment of peptic ulcer efficacy and cure of traditional Chinese medicine effective symptom by some traditional Chinese medicine as to as ranitidine(P=0.56,P=0.08);and HP conversion rate of HP-positive peptic ulcer patients did not differ significantly ranitidine(P=0.10),and not differ significantly ranitidine+ Amoxicillin + metronidazole [RR=1.60(95%CI:0.94,2.73],and differ significantly Omeprazole+Amoxicillin + tinidazole,RR=0.08(95%CI:0.03,0.23].Conclusion:1. The research of PU through TCM treatmentThe common syndrome of PU are: spleen and stomach deficiency, liver and stomach Qi stagnation, blood stasis stagnation card, stomach yin deficiency syndrome, stomach heat flaming card, hot and humid in the resistance card. spleen and stomach deficiency is the main mechanism for peptic ulcer, and for ulcer recurrence. Treatment of spleen and stomach deficiency card to Liujunzi Tang, Astragalus Decoction, the rationale for the commonly used prescriptions in the Tang may be appropriate to increase myogenic acid drug use, compatibility qi and blood circulation, detoxification of the goods; liver and stomach Qi stagnation to Bupleurum Liver Powder, Jin Ling Zi Powder as the commonly used formulas, with the blood detoxification, and spleen, tissue regeneration acid of the goods; stasis stagnation card to Shixiaosan, Salvia drink, Jin Ling Zi Powder as the common prescription, compatibility Notoginseng, red peony root, peach kernel, Chuanxiong, safflower and other blood circulation, spleen qi Qi and blood compatibility, detoxification of chemicals; stomach yin deficiency syndrome in Yiwei Tang, wheat Asp soup, peony and licorice soup For commonly used prescription, compatibility acid, spleen qi nourishing of the goods; stomach heat flaming card to berberine, dandelion, gardenia, peony tree bark, skullcap Qingrejiedu, compatibility qi and blood circulation and tissue regeneration acid, the spleen of the goods; Heat retention syndrome commonly used in drugs to berberine, Pinellia, Poria, skullcap, herb, dandelion, magnolia, gardenia, Coix seed and other heat and dampness, compatibility myogenic acid, spleen Qi of the product. No matter what type of treatment cards are more or less medication Astragalus, Atractylodes drugs such as spleen Qi and Baiji, cuttlefish bone, corrugated sub-acid drugs such as tissue regeneration to improve the efficacy. 2. Professor Zhou Xuewen experience in treatment of peptic ulcer and Data MiningProfessor Zhou Xuewen instructors for the clinical characteristics of peptic ulcer and endoscopic changes to the "stomach carbuncle" disease name, and innovation "toxic heat”theory that the pathogenesis of the spleen and stomach-oriented, heat Accumulation as the standard drug, chronic illness into the network, Blood stasis to change. That "the carbuncle on the administration " thought the treatment would "eliminate","care","up " three methods to introduce treatment to detoxify, eliminate the main governing myogenic carbuncle law, establishing the main prescription consumer health carbuncle may collapse, Clinical randomized conditioning, pay attention to the compatibility of drug application, emphasizing in particular handle well the liver and spleen, stomach, gall bladder relationship, pay attention to adjust the air-lift, the appropriate use of blood circulation, nourish Stomach-Yin and Yang Xin of the goods transferred spleen, and can for Helicobacter pylori Pylori (hp) and improved treatment efficacy. Stressed out watching the tongue to advance and retreat of disease prognosis, drug dosage should not be too large, attention to diet ,extracting and taking drugs method.3. The system evaluation of the treatment to PU by using TCM endoscopic treatment of peptic ulcer cure and efficacy of traditionalChinese medicine effective symptom by some traditional Chinese medicine is better than ranitidine, six months and one year recurrence rate of ulcers lower than ranitidine;endoscopic treatment of peptic ulcer efficacy and cure of traditional Chinese medicine effective symptom by some traditional Chinese medicine as to as ranitidine;and HP conversion rate of HP-positive peptic ulcer patients did not differ significantly ranitidine, not differ significantly ranitidine+ Amoxicillin + metronidazole ,and differ significantly Omeprazole+Amoxicillin + tinidazole.Because all of the methodological quality and evidence of low quality, the results of this study should be cautious in the future and should be more Specifications research design, extended follow-up time, pay attention to drug safety and adverse reactions, and in accordance with the medical report of randomized controlled trials of standardized (CONSORT for TCM) in the recommended process and project reporting RCT.