| Purpose:By collecting randomized controlled trials(RCTs)on the treatment of chronic pancreatitis with integrated traditional Chinese and Western medicine,the Meta-analysis evaluates the efficacy of integrated traditional Chinese and Western medicine compared with Western medicine in the treatment of patients with chronic pancreatitis,and provides important evidence-based medical evidence for the treatment of chronic pancreatitis by integrated traditional Chinese and Western medicine.Materials and Methods:The Chinese and English databases are fully searched by computer.The English database includes:Pubmed,Google schalor,and Cochrane Library.Chinese library includes:Chinese BioMedical Literature Database(CBM),China National Knowledge Infrastructure(CNKI),Wanfang Database,Chongqing VIP Database(VIP).The starting and ending time of searching for documents is from the time of building the library to2011.08.03.Comprehensively search the relevant literatures in Chinese and English databases at home and abroad,and screen the articles on randomized controlled clinical trials on the efficacy of integrated traditional Chinese and Western medicine in the treatment of chronic pancreatitis.According to the established inclusion and exclusion criteria,the two reviewers independently completed the collection and screening.Uncertain articles may be requested to be arbitrated by a third party expert.The quality of the articles included in the study was scored using the improved Jadad quality evaluation criteria.Extract the basic information of the article and input it into RevMan5.3 software for risk bias evaluation.Data were collected from the end point of the literature,and Meta-analysis was performed using RevMan5.3software to obtain a forest map,a funnel plot,and subgroup analysis and sensitivity analysis when necessary.Results:According to the established inclusion and exclusion criteria,a total of 16 articles and1,255 patients were enrolled in the study,and the selected articles were all in Chinese.The improved Jadad quality score showed that the quality of the literature is generally not high,ranging from 2-3 points.The Meta-analysis of each clinical endpoint showed that the total effective rate and recurrence rate of the integrated Chinese and Western medicine treatment group compared with the Western medicine were:[OR 3.37,95%CI(2.38,4.78),Z=6.82,P<0.00001]、[OR 0.04,95%CI(0.01,0.10),Z=6.40,P<0.00001],the difference between the two groups was statistically significant,It shows that the combination of traditional Chinese medicine and western medicine has higher efficiency and lower recurrence rate than the western medicine routine treatment group;the funnel plot of 14 articles recording the total effective rate of this endpoint showed that the scatters were evenly distributed,symmetric,and all in the 95%confidence interval.It shows that there is little possibility of publication bias.Clinical symptom scores such as abdominal pain score,abdominal distension score,diarrhea score,jaundice score,dyspepsia score:[SMD-0.94,95%CI(-1.20,-0.67),Z=6.95,P<0.00001]、[SMD-1.16,95%CI(-1.43,-0.89),Z=8.37,P<0.00001]、[SMD-0.82,95%CI(-1.08,-0.55),Z=6.12,P<0.00001]、[MD-0.40,95%CI(-0.51,-0.28),Z=6.70,P<0.00001]、[MD-0.43,95%CI(-0.60,-0.27),Z=5.10,P<0.00001],the difference between the two groups has statistical significance,indicating that the combination of traditional Chinese and Western medicine can significantly improve the clinical symptoms,the effect is better than the western medicine routine treatment group.Laboratory indicators:lipase:[MD-18.02,95%CI(-24.52,-11.53),Z=5.44,P<0.00001],the difference between the two groups was statistically significant;blood amylase,paraoxonase[SMD 0.16,95%CI(-0.56,-0.88),Z=0.44,P=0.66],[MD-25.41,95%CI(-77.44,-128.26),Z=0.48,P=0.63],two The differences between the groups were not statistically significant and heterogeneity.Further subgroup analysis and sensitivity analysis found that age may be the cause of bias.After excluding the biased articles,the results were statistically significant and showed no significant heterogeneity:[SMD-0.49,95%CI(-0.81,-0.18),Z=3.06,P=0.002;I~2=0%],[MD 76.64,95%CI(42.61,110.66),Z=4.41,P<0.0001;I~2=0%].It shows that the recovery effect of the integrated Chinese and Western medicine group on laboratory indicators is better than that western medicine routine treatment group.Age may be a factor that causes heterogeneity.Other factors may also affect the results.Therefore,the two results should be interpreted with caution.Conclusion:Meta-analysis shows that the combination of Chinese and Western medicine has a better advantage than Western medicine.It has shown good efficacy in improving total efficiency,reducing recurrence rate,promoting improvement of symptoms,and recovery of laboratory indicators.The treatment of traditional Chinese medicine relies on the angle of liver stagnation and spleen deficiency,as well as the aspects of qi,dampness,phlegm and blood stasis.It can achieve both the specimen and the sample through the methods of smoothing the liver and strengthening the spleen,clearing away heat and dampness,promoting blood circulation and removing blood stasis,replenishing spleen and stomach,etc.Improve the symptoms and improve the efficacy.However,because the methodological quality of all the collected documents is not very high,most of the random methods are not mentioned.The blind method is not clear,and the withdrawal cases are unknown.There are inconsistencies in the application of traditional Chinese medicine(formulation,dosage,treatment,etc.)in the intervention process.It is impossible to reach a clear conclusion.Therefore,in order to increase the reliability and clarity of the clinical efficacy of CP,it is still necessary to conduct a rigorous,multi-center,large-scale,prospective,randomized trial. |
