Meta Analysis On The Clinical Effect Of Traditional Chinese Medicine On Prevention Of Gallstone Recurrence After Choledochoscopic Gallbladder-preserving Cholecystolithotomy

Objective:Meta analysis is used to have a further clarification of the effectiveness and safety of traditional Chinese medicine in preventing the recurrence of cholecystolithiasis after choledochoscopic gallbladder-preserving cholecystolithotomy,also in order to offer a theoretical basis for the establishment of the indications of cholecystolithiasis and the prevention of the recurrence of cholecystolithiasis,so as to provide a more objective and reliable evidence-based medical basis for the prevention of the recurrence of cholecystolithiasis after choledochoscopic gallbladder-preserving cholecystolithotomy by traditional Chinese medicine.Materials and methods:Chinese and English randomized controlled experiments published in CNKI,Wanfang Data,VIP,CBM,PubMed and web of science were collected by computer retrieval from the establishment of the database to December 2020.A screening group is formed by three reviewers.First,two reviewers independently screened the documents according to the pre-defined criteria of inclusion and exclusion,then initially excluded the documents that did not meet the requirements,and sorted out the preliminary standard-compliant literature,and then the two reviewers read the full text intensively.If there were any differences,these two reviewers would have the discussion and consultation according to their different opinions,or the third reviewer would do the analysis and rule out the conclusion,afterwards the final pre-defined documents were determined,and then conduct the quality control and data abstraction,through Meta analysis performed by Stata12.0 software.Results:12 randomized controlled trials of traditional Chinese medicine were included,were all Chinese literature,including 1077 patients,among which 538 were study groups and 539were control groups.Meta analysis results showed:(1)recurrence rate of gallstone:11 studies reported the recurrence rate of gallstone.The recurrence rate of the stones in the experimental group was lower than that of the control group,or=0.20,95%CI(0.12,0.33),P<0.0001;(2)gallbladder wall thickness:11 studies reported the evaluation index of the thickness of gallbladder wall,and the decrease of gallbladder wall thickness in the experimental group was better than that of the control group after choledochotomy,MD=-0.65,95%CI(-0.83,-0.48),P<0.0001;(3)gallbladder contraction rate:a total of 11 studies reported the gallbladder contraction rate.The experimental group improved the level of gallbladder contraction after choledocholithotomy compared to the control group,MD=12.52,95%CI(9.29,15.75),P<0.0001.The difference between the experimental group and the control group was statistically significant(P<0.05).Conclusion:the result of this study shows that Chinese medicine is better than the conventional therapy of western medicine in preventing the recurrence of gallstone after choledocholithotomy,and the Chinese medicine can significantly improve the gallbladder contraction rate,reduce the thickness of gallbladder wall,and have less adverse reactions.