Systematic Review Of Huangqi Jianzhong Decoction In The Treatment Of Chronic Atrophic Gastritis With Weakness Of Spleen And Stomach

Objective: searching for the literature of Huangqi Jianzhong Decoction in the treatment of chronic atrophic gastritis(CAG)with weakness of spleen and stomach,the effect of Huangqi Jianzhong Decoction on clinical efficiency,TCM syndrome score,pathological score,main symptom score,HP clearance rate,recurrence rate,inflammatory factors and adverse reactions of CAG patients with spleen stomach weakness was evaluated by meta-analysis.The purpose of this systematic evaluation is to provide evidence-based evaluation for the clinical efficacy and safety of Huangqi Jianzhong Decoction in the treatment of spleen stomach weakness CAG.Methods: the randomized controlled trial(RCT)of Huangqi Jianzhong Decoction for the treatment of CAG with weakness of spleen and stomach was searched in CNKI,VIP,Wang Fang,Pub Med,Cochrane Library and Embase from inception to January 2020.Data extraction and methodological quality evaluation were carried out independently by two researchers.The quality evaluation was carried out by using Cochrane system evaluator's manual.Meta analysis was carried out by Using Stata 12.0 software.Heterogeneity sources were explored by subgroup analysis and sensitivity analysis.Results: 24 RCTs,involving 406 patients,were included in the analysis.Meta analysis showed that: 24 studies reported the Clinical efficiency of Huangqi Jianzhong Decoction in the treatment of spleen stomach weakness CAG.The results showed that Huangqi Jianzhong Decoction can significantly improve the Clinical efficiency(OR=5.67,95%CI[4.14,7.78],p = 0.000).4 studies reported the improvement of the symptom score of stomachache.2 studies reported the improvement of the symptom score of gasteremphraxis.3 studies reported the improvement of the symptom score of poor appetite and loose stool.4 studies reported the improvement of acid reflux and belching.The results showed that Huangqi Jianzhong Decoction could improve stomachache(WMD=-0.64,95%CI[-0.66,-0.62],p = 0.000),gasteremphraxis(WMD=-0.67,95%CI[-0.73,-0.61],p = 0.000),poor appetite and loose stool(WMD=-0.69,95%CI[-0.84,-0.55],p = 0.000),acid reflux and belching(WMD=-0.57,95%CI[-0.76,-0.37],p = 0.000).6 studies reported the recurrence rate.The results showed that Huangqi Jianzhong Decoction can significantly reduce the recurrence rate(OR=0.10,95%CI[0.04,0.23],p = 0.000).5 studies reported the clearance rate of HP.The results showed that Huangqi Jianzhong Decoction could improve the clearance rate of HP(OR=2.83,95%CI[1.84,4.34],p = 0.000).Conclusion: This study shows that Huangqi Jianzhong Decoction can improve the clinical efficiency,the main symptom scores,the HP clearance rate and reduce the recurrence rate,suggesting that it has a good effect in the treatment of CAG.It also has potential curative effect and advantage in TCM syndrome score,pathological score,adverse reactions and inflammatory factors.In the future,more clinical studies with higher methodological quality on the hard indexes such as pathological improvement are needed,and more studies on the mechanism are also expected to further verify its clinical efficacy and safety.