Systematic Review And Meta-Analysis Of The Method Of Promoting Blood Circulation And Removing Blood Stasis In Treating Ulcerative Colitis

Ulcerative Colitis is a chronic non-specific inflammatory disease.The major symptoms of UC are abdominal pain,diarrhea,bloody purulent stool and tenesmus.The etiology and pathogenesis of this disease are generally believed to be related with the environment,diet,immune function,heredity gene and the change in intestinal microbial structure ^[1] without a clear-out conclusion.The therapeutic schedules developed by different grades,stages and sections are used in Western Medicine.The UC is classified as "Xia Li","Jiu Xie","Jiu Li","Chang Pi" and "Dysentery" according to its symptoms in Traditional Chinese Medicine without a certain name.It is believed that^[2,3]Benxu and Biaoshi are the root causes of its onset in Traditional Chinese Medicine.The advantage of the treatment of Traditional Chinese Medicine is that it can control the number of attacks and the interval time as well as alleviate the clinical symptoms of patients.The main principles are clearing heat and eliminating dampness clinically,invigorating Qi and spleen,promoting blood circulation and removing blood stasis.Among them,the method of promoting blood circulation and removing blood stasis is an important method in treating UC.EBM?evidence-based medicine?,also known as Empirical Medicine,is used to obtain "best evidence" to guide clinical treatment,nursing,diet and other aspects.EBM provides scientific and objective decision-making support for clinical medical diagnosis and treatment,so as to obtain the best diagnosis and treatment plan and improve the quality of life.Objective:From the perspective of EBM,a systematic review and meta-analysis of the effective rate and safety of the method of activating blood and removing blood stasis in treating UC is provided,which provides a more reliable and accurate basis for the method of activating blood and removing blood stasis in treating UC.Methods:Fristly,searching the databases in both Chinese and English,including China National Knowledge Infrastructure?CNKI?,Wanfang Database,China Biology Medicine disc?CBMdisc?,Pub Med,Embase,Web of science and the clinical trial registration databases of the Cochrane Library.The databases were searched from the date of construction to March 2019.After that,finding randomized controlled trials?RCT?about activating blood circulation and removing blood stasis method for UC.Different databases adopted different search strategies to retrieve documents.Two independent researchers applied Note Express software to screen the documents to obtain documents that met the inclusion requirements.Followed by using an Excel sheet to specify the data extraction table to extract the data.The Cochrane bias risk assessment form was used to evaluate the risk of bias in the included literature.Rev Man5.3 software performed relevant data analysis.Results:A total of 13 literatures and 1285 patients were included.According to the bias risk assessment tool provided by the Cochrane systematic review manual,the quality of the included literature was evaluated,and the included literature was of low to medium quality.Analyze selected relevant indicators,of which the main indicator analysis results: 1.Effective rate: The effective rate of the method of activating blood circulation and removing blood stasis is better than that in the control group?RR = 1.19,95% CI = [1.10,1.29],P <0.0001?.2.Recurrence rate: The recurrence rate of the method of activating blood circulation and removing blood stasis is lower than that in the control group?RR = 0.32,95% CI = [0.17,0.60],P = 0.0003?.3.Safety: The safety of the method of activating blood circulation and removing blood stasis remains to be discussed,and further research is needed to verify it.Conclusions:1?At present,there is insufficient evidence to prove that the effective rate of the method of promoting blood circulation and removing blood stasis alone is better than that of western medicine.However,combining western medicine treatment with blood circulation and removing blood stasis has clear therapeutic advantages.The administration of the medicine including oral,enema or oral combined with enema all have therapeutic effects.The medication course is within 8 weeks,and the method of promoting blood circulation and removing blood stasis has a clear effect on UC.2?The recurrence rate of treating UC by promoting blood circulation and removing blood stasis is low.3?The current research has not yet been able to evaluate the safety of the method of promoting blood circulation and removing blood stasis in the treatment of UC.4?The research on the treatment of UC by activating blood circulation and removing blood stasis requires more large-sample,multi-center randomized controlled blind trials.