A Systematic Review Of TCM In Treating Chronic Atrphic Gastritis

Background: The chronic atrophic gastritis(CAG) is a common disease in the digestive system with a high rate of incidence. According to many researches, the treatment of traditional Chinese medicine(TCM) in CAG accumulate much effective experience and many methods. But because methodologies of TCM clinical researches are weak in use, the standardized of clinical trials are less, clinical effect lack of objective and scientific evaluation, that research results are difficult to be recognized and promoted. Systematic Review recognized in the international medical profession, expanding systematic review facilitate the search for an effective drugs, methods, technology, measures, etc, this can provide constructive comments and promote the development of TCM.Objective: To systematically realize the problems in the TCM clinical researches of CAG, and to evaluate the quality of these researches. To make the systematic review of the curative effect of the TCM treatment to the CAG, so that clinical treating decision can be made based on objective believable evaluation of the treatment.Methods: Use the data base to searches literatures during 1997～2007 years. Investigate the clinical effect of TCM that it helps the CAG. According to inclusion-criteria and exclusion-criteria, filtrate the literatures. Based on the principle and the method of DME, formulate the Systematic Review Table of the treatment article of TCM to the CAG. It has made statistic analysis from several lines. Such as randomization, the balance of groups, the inclusion and exclusion criteria, control, samplesize, blind-method, statistics method, objects sdandardization, the effect judgement standardization, etc. Calculate the percentage of all kinds of states and evaluate the quality. Then utilize the RevMan to procee Meta analysis.Results: 1 have recalled the literatures about the TCM treatment to the CAG 541 pieces in all, only 47 clinical controlled trials in line with the inclusion criteria. In diagnostic criteria, there are 17 pieces(36.17%) adopting the TCM diagnosis with Western medicine diagnostic criteria; 1 pieces(2.13%) only adopting the TCM diagnostic criteria; 25 pieces(53.19%) only adopting the Western medicine diagnostic criteria. 12 pieces(25.53%) have a clear, fit into the inclusion-criteria, and with the purpose of Chapter; 24 pieces(51.06%) inclusion-criteria description only scattered or description. 11 pieces(21.40%) literature that may affect the authenticity of the main conclusions of mixed- establishment of a reasonable clear exclusion-criteria, 31 pieces (65.96%) without any documentation exclusion-criteria described . All researches have clear and appropriate efficacy standards, and 33 pieces(70.21%) using national institute standards. The whole randomized quality is rather low. There are 7 pieces(14.89%) are randomization perfectly, 2 pieces(4.26%)are false randomization, 1 piece(2.13%) is half randomization, and the other 37 piece(78.72%) did not mention any specific random. There are only 1 pieces(2.13%) referring to random assignment controlled by center for the scaled envelopes. Only 2pieces(4.26%) used blind-method(one is the double blind-method, and the other is single blind-method). Most of the studies simple statement of the Group as the average age, sex, course of disease. There are 24 pieces(51.06%) that made the statistical analysis the balance of groups and clearly stated the p was less than 0.05, 7 pieces(14.89%) showed the words of "balanced" and so forth. There are 45pieees(95.74%) correctly using statistical methods, 14 pieces 29.79%) not specify the statistical method. 7 pieces(14.89%) mentioned the adverse events in each group of symptoms and a few cases, but all these 7 researches did not recorded adverse reactions or events.The result of Meta analysis is:The clinical efficacy, the gastroscopy efficacy, the pathologic efficacy , and the rate of eliminating Hp of the random group are better than that of the TCM control group. The differences have statistical significance.Conclusion: The quantity of clinical random control trials(RCT) is few, and the quality of RCT is low. According to the Meta analysis, the TCM treatment to CAG can alleviate the patients' symptoms, lighten the pathological changes of gastric mucosa, and increase the rate of eliminating Hp. Existing research finding does not preclude the treatment group and the control group between the effects maybe significant differences in test methodologies for low quality, have yet to stringent design of the sample, multi- center, randomized, placebo-controlled, parallel placebo in clinical trials to be confirmed.