目的:运用Meta分析方法,系统评估疏肝健脾法治疗慢性胃炎伴焦虑抑郁的安全性及有效性,为临床治疗伴有焦虑抑郁状态的慢性胃炎患者提供循证依据.方法:检索Cochrane library、EMBASE、PubMed、Web of science、中国知网、万方数据库和维普数据库中所有关于疏肝健脾中药治疗慢性胃炎伴焦虑抑郁患者的随机对照试验,按照纳入和剔除标准筛选文献,采用Jadad评分量表对纳入文献进行质量评价,运用RevMan 5.4软件进行Meta分析,结局指标包括临床疗效、胃镜有效率、焦虑及抑郁评分和中医症状积分.结果:研究共纳入22篇文献,涉及2 229例患者,其中治疗组1 129例,对照组1 100例.Meta分析结果显示,与对照组相比,疏肝健脾法治疗组临床疗效较高[OR= 4.14,95%CI(3.10,5.54),P<0.000 01],胃镜疗效较好[OR = 2.47,95%CI(1.66,3.67),P<0.000 01],焦虑自评量表(Self-Rating Anxiety Scale,SAS)[MD =-8.37,95%CI(-11.66,-5.08),P<0.000 01]及汉密尔顿焦虑量表(Hamilton Anxiety Scale,HAMA)[MD=-5.01,95%CI(-6.45,-3.57),P<0.000 01]评分较低,抑郁自评量表(Self-Rating Depression Scale,SDS)[MD =-7.75,95%CI(-12.47,-3.03),P = 0.001<0.01]及汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD)[MD =-5.07,95%CI(-7.24,-2.90),P<0.000 01]评分较低,中医症状(包括胃痛、胃胀、反酸、嗳气)积分较低,差异均有统计学意义,且治疗组不良反应较少.结论:疏肝健脾法治疗慢性胃炎伴焦虑抑郁患者在提高临床疗效和安全性等方面优于单独西药治疗,疏肝健脾法可以改善患者胃肠道不适症状,缓解焦虑抑郁状态,具有良好的应用前景.
Objective:Meta analysis was used to evaluate the efficacy of the Shugan Jianpi method(疏肝健脾法)on chronic gastritis with anxiety and depression,so as to provide basis and ideas for clinical treatment.Methods:Cochrane library,EMBASE,PubMed,Web of science,CNKI,Wanfang database and VIP database were searched for all randomized controlled trials on the treatment of chronic gastritis patients with anxiety and depression by the Shugan Jianpi method.Jadad scoring scale was used to evaluate the quality of the included literature,and RevMan 5.4 software was used for Meta-analysis.Outcome indicators include clinical efficacy,gastroscopy efficacy,anxiety and depression scores,and traditional Chinese medicine symptom scores.Results:22 studies with a total of 2 229 patients were included,of whom 1 129 received therapy and 1 100 did not received.Based on the Meta-analysis,compared with the control group,the treatment group with the Shugan Jianpi method had higher clinical efficacy[OR=4.14,95%CI(3.10,5.54),P<0.000 01],better gastroscopy efficacy[OR=2.47,95%CI(1.66,3.67),P<0.000 01],the anxiety scores of SAS[MD=-8.37,95%CI(-11.66,-5.08),P<0.000 01],and HAMA[MD=-5.01,95%CI(-6.45,-3.57),P<0.000 01]were lower.Depression scores of SDS[MD=-7.75,95%CI(-12.47,-3.03),P=0.001<0.01]and HAMD[MD=-5.07,95%CI(-12.47,-3.03),P<0.000 01]were lower,and the scores of TCM symptoms(including stomach pain,bloating,acid reflux,belching)were lower,with statistically significant differences,and the treatment group had fewer adverse reactions.Conclusion:The Shugan Jianpi method is superior to western medicine alone in improving clinical efficacy and safety in treating patients with chronic gastritis accompanied by anxiety and depression.The Shugan Jianpi method can improve gastrointestinal discomfort symptoms in patients,alleviate anxiety and depression,and has good application space and prospects.