Meta Analysis Of Ulcerative Colitis Treated By Traditional Chinese Medicine Syndrome Differentiation

Objective:The clinical randomized controlled trial of simple traditional Chinese medicine under the guidance of syndrome differentiation and treatment compared with simple mesalazine in the treatment of ulcerative colitis was taken as the object of study,a meta-analysis was conducted to explore the effectiveness and security of Chinese medicine in treating UC,so as to provide evidence-based suggestions for clinical treatment of UC.Methods:Pubmed,Embase,Cochrane Library,American Clinical Trials Registry published and unpublished articles from the establishment of the database to 2019were searched,and CNKI,CBM,WANFANG,VIP,Chinese Clinical Trials Registry published and unpublished RCT literatures about oral mesalazine oral treatment of UC from 2015 to 2019 were searched.Two participants screened the literatures and extracted the data according to the criteria.Cochrane bias risk assessment tool was used to assess the quality of selected literature.Finally,using Revman5.3 or Stata15.1meta analysis software for the selected data.Results:Finally included 12 RCT documents.There were 1038 UC patients.Compared with mesalazine,the total effective rate,the efficacy of colonoscopy,the serum IL-17 level and the incidence of adverse reactions in oral treatment of UC with traditional Chinese medicine were not heterogeneity after heterogeneity testing.After using the fixed effect model combined with RR,the total effective rate(I~2=0%,95%CI:1.15?1.2,P=0.00001),the efficacy of colonoscopy(I~2=0%,95%CI:1.13?1.65,P=0.001),and the level of IL-17(I~2=0%<50%,95%CI:-1.35?-0.82,P<0.00001),The incidence of adverse reactions(I~2=12%,95%CI:0.46?1.16,P=0.19);Diarrhea,mucopurulent and bloody stool,abdominal pain score,total symptom score,enteroscopy score and he level of TNF-?showed heterogeneity after heterogeneity test,and there was no essential change in sensitivity.After adopting random effect model combined with effect dose SMD,diarrhea score(I~2=98%,95%CI:-3.78?-0.85,P=0.002),mucopurulent and bloody stool score(I~2=98%,95%CI:-4.23?-0.49,P=0.01),and abdominal pain score(I~2=94%,95%CI:-2.69?-0.91,P<0.0001),total symptom score(I~2=87%,95%CI:-2.41?-1.00,P<0.00001),colonoscopy score(I~2=85%,95%CI:-1.14?-0.14,P=0.01),the level of TNF-?(I~2=85%,95%CI:-2.84?-0.68,P=0.001).The tenesmus score and CRP level were heterogeneity after heterogeneity test.After excluding the heterogeneity study by sensitivity analysis,the fixed effects model was used to combine the effect amount of SMD:the tenesmus score I~2=0%,95%CI:-1.45?-0.87,P<0.00001)and the level of CRP(I~2=33%,95%CI:-1.80?-1.12,P<0.00001).Conclusion:This study shows that the clinical effect of oral administration of traditional Chinese medicine under the guidance of syndrome differentiation in the treatment of UC is significantly better than that of oral mesalazine alone,and oral treatment of traditional Chinese medicine can better relieve clinical symptoms,improve intestinal mucosal injury and accelerate the healing of intestinal mucosa,reduce the levels of CRP,IL-17,TNF-?and so on.The incidence of adverse reactions is similar to that of oral mesalazine,and there is no obvious side effect.However,it is still necessary to carry out higher-quality clinical research to analyze and prove it,in order to provide higher-quality evidence of evidence-based medicine.