Meta-Analysis And Tmedication Rules Of Modern Clinical Application On Treatment Of Acute Icteric Hepatitis By Clearing Heat,Leaching Wet And Activating Blood

Objective:To investigate the effectiveness of formulas related to the treatment of acute jaundice from the method of clearing heat,promoting dampness and invigorating blood,as well as the clinical efficacy of improving liver function-related indexes,and to analyze the dosing pattern of this method to provide evidence-based basis for clinical treatment.Methods:Searching for all studies published between 1981 and December 2021 was the target of our search.Seven databases were used for the survey:Wanfang database(WF),China Journal Full Text Database(CNKI),Vipers Chinese Science and Technology Journal Full Text Database(VIP)and Chinese Biomedical Literature Database CBM,PubMed,EMBASE,Cochra Library.The literature was screened according to the established inclusion and exclusion criteria,the required literature information was extracted,and the quality of the included literature was evaluated using the Jadad rating scale.A meta-analysis was performed on the experimental data using RevMan 5.3 software,and a forest plot expressing the relevant results and a funnel plot indicating the publication bias of the literature were produced.The frequency and pattern of medication use in the included literature meeting the requirements were then summarized and statistically analyzed.Results:The results of the meta-analysis showed that there was homogeneity among the studies in the included 16 papers,and the efficacy of the experimental group was better than that of the conventional Western medicine group,and the clinical efficiency of the oral herbal medicine for clearing heat and dampness and activating blood circulation was higher than that of the control group(OR=5.91,95%CI[3.91,8.93],P<0.00001.);the clinical cure rate,better than that of the treatment with Western medicine alone(OR=2.85,95%CI[2.20,3.70],P<0.00001.);reduction of ALT,better than western drug treatment alone(MD=-28.15,95%CI[-44.75,-11.56],P=0.0009.);reduction of TBIL,better than western drug treatment alone(MD=-16.46,95%CI[-26.06,-6.85],P=0.0008);lowering AST was significantly more effective than the control group(MD=-22.36,95%CI[-36.25,-8.48],P=0.002).The above test group was better than the control group,while there was no significant difference between the test group and the control group for the effects of DBIL,γ-GT,and TCM symptoms including body and eyes yellow,chest and abdominal distension,and dry mouth and bitterness.The frequency and regularity of medication use in TCM:The frequency and regularity of medication use were analyzed for 16 papers that met the criteria,in which there were 51 relevant TCMs and 161 flavor counts were the total frequency of use.In the statistics,it was found that all these drugs were mainly single-flavored drugs.Among them,24 kinds of Chinese medicines were used≥2 times,which occurred 134 times in total,accounting for 83.22%of the total medication frequency,and 27 kinds of Chinese medicines occurred less than twice,which was 16.78%of the total medication frequency.12 kinds of Chinese medicines appeared more than 4 times,and the order of frequency from high to low was:Yin Chen,Fu Ling,Dan Shen,Red Peony,Rhubarb,Money Grass,Gardenia,Chai Hu,Yu Jin,Gan Cao,Tiger Stick,Huang Qi.According to the cluster analysis dendrogram,three clusters were obtained:C1:Yin Chen,Fu Ling,Danshen,Rhubarb,Radix et Rhizoma;C2:Yin Chen,Fu Ling,Danshen,Yu Jin,Radix et Rhizoma;C3:Yin Chen,Chen Pi,Rhizoma,Radix et Rhizoma,Radix et Rhizoma,Radix et Rhizoma,Radix et Rhizoma.Conclusion:In this paper,the specific effects of the method of clearing heat and dampness and invigorating blood in the treatment of acute jaundice were studied by Meta-analysis.The overall effective rate was significantly better than that of western medicine when combined with western medicine in the treatment of acute jaundice.The combination of this therapy with western medicine was effective in reducing the indexes related to liver function.The data mining results showed that the treatment of acute jaundice with the method of clearing heat and dampness and invigorating blood was dominated by bitter,sweet,pungent and cold drugs,drugs of the spleen,stomach,liver and lung meridians,mostly applied to diuretic and dampness,clearing heat,invigorating blood and resolving blood stasis,supplemented by tonic,diaphoretic and dampness dissolving drugs.The core prescription consists of Yin Chen,Fu Ling,Dan Shen,Red Peony and Da Huang.