Meta-Analysis And Data Mining Of The Treatment Of Chronic Atrophic Gastritis With Traditional Chinese Medicine

Objective: To apply Meta-analysis method to evaluate the clinical efficacy and safety of traditional Chinese medicine(TCM)oral prescription in the treatment of chronic atrophic gastritis,and to use "Traditional Chinese Medicine Inheritance Computing Platform(V3.0)" related data mining technology for the Chinese medicine involved;To provide evidence-based medical evidence and clinical medication reference for clinical treatment.Methods: Search Sino Med,CNKI,Wanfang Database,VIP,Cochrane Library,Embase,Pub Med seven databases according to the established search strategy,and searched conference papers the randomized controlled clinical trial of TCM(decoction and decoction free granules)for the treatment of chronic atrophic gastritis.The time limit is from the date of establishment to October 31,2022.Researchers independently screened the literature and collected research data based on the inclusion and exclusion criteria,used the Cochrane Collaboration’s bias risk assessment tool to evaluate the literature,used Rev Man 5.3 software to perform meta-analysis,and included The prescriptions of the literature are entered into the "Traditional Chinese Medicine Inheritance Computing Platform(V3.0)" to explore the rules of medication for the treatment of chronic atrophic gastritis with TCM oral prescription.Results:1.Meta-analysis: Finally,45 RCT studies on the treatment of chronic atrophic gastritis with TCM oral prescription were finally obtained.There were 4679 patients in total,including 2494 patients in the experimental group and 2185 in the control group.TCM oral prescription combined with conventional treatment is significantly better than conventional treatment alone in the treatment of chronic atrophic gastritis [RR=1.25,95%CI(1.20,1.30),P< 0.00001];TCM oral prescription is better than conventional therapy alone for Symptom effectiveness and Gastroscope effect in the treatment of chronic atrophic gastritis([RR=1.34,95%CI 为 1.24-1.45,Z=7.56,P<0.00001];[RR=1.34,9 5%CI[1.25,1.43],Z=8.74,P<0.00001]).TCM oral prescription is better than conventional therapy alone for Total pathological effect and pathological effect of mucosal gland atrophy in the treatment of chronic atrophic gastritis([RR=1.64,95%CI 为 1.47-1.84,Z=8.51(P<0.00001)];[RR=1.55,95%CI=[1.35,1.80],Z=6.01,P<0.00001]).TCM oral prescription is better than conventional therapy alone for Mucosal intestinal metaplasia pathology and pathological effect of mucosal dysplasia in the treatment of chronic atrophic gastritis([RR=1.66,95%CI=[1.32,2.07],Z=4.41,P<0.00001];[RR=1.43,95%CI=[1.07,1.90],Z=2.42,P=0.02]).HP negative conversion rate in the treatment group was higher than that in the control group:[RR=1.24,95% CI [1.14,1.36],P<0.0001];TCM oral prescription has fewer adverse reactions in the treatment of chronic atrophic gastritis than simple conventional treatment [RR= 0.26,95%CI=[0.14,0.46],P<0.00001].2.Medication rules: There are 66 prescriptions for the treatment of chronic atrophic gastritis by internal administration of traditional Chinese medicine,of which 125 Chinese herbs are involved;And the prescriptions for the treatment of chronic atrophic gastritis are good use of tonifying deficiency drugs,regulating qi and promoting blood circulation and removing blood stasis drugs.The common syndrome types are spleen and stomach weakness syndrome and liver and stomach qi stagnation syndrome.The drugs used are mainly attributed to the lung and spleen and stomach meridians.The main property of medicine was temperatureness,bitter,and pungent.In addition to licorice,the total frequency of drugs is 687,and the top 30 are atractylodes macrocephala,white peony,astragalus,poria cocos,codonopsis pilosula,angelica sinensis,orange peel,salvia miltiorrhiza,red peony and so on.With a support of 20%and a confidence of 90%,six traditional Chinese medicines can be obtained,including atractylodes macrocephala,white peony,codonopsis pilosula,astragalus root,poria cocos and tangerine peel.The three association rules are Codonopsis pilosula,Poria cocos → Atractylodes macrocephala,Poria cocos,Astragalus → Atractylodes macrocephala,Poria cocos → Atractylodes macrocephala.11 drug pairs,including atractylodes macrocephala,codonopsis pilosula,atractylodes macrocephala,paeonia lactiflora,paeonia lactiflora,poria cocos,atractylodes macrocephala,tangerine peel,codonopsis pilosula,poria cocos,atractylodes macrocephala,codonopsis pilosula,poria cocos,astragalus,atractylodes macrocephala,poria cocos,codonopsis pilosula,astragalus,poria cocos and astragalus.The clustering analysis,four groups of new prescription combinations can be obtained.Group 1: stragalus,atractylodes macrocephala,tuckahoe,codonopsis pilosula,paeonia lactiflora,and salvia miltiorrhiza;Group 2: Codonopsis pilosula,Atractylodes macrocephala,Rhizoma coptidis,Poria cocos,Radix paeoniae alba,Radix bupleuri;Group 3: magnolia officinalis,citron,orange peel,pinellia ternata,white peony and bergamot;Group 4: angelica,panax notoginseng,typhus,astragalus,corydalis,and faeces trogopteri.Conclusion: 1.The results of meta-analysis showed that the traditional Chinese medicine(decoction and traditional Chinese medicine without decocting granules)had certain advantages in improving the effective rate of clinical comprehensive effect,gastroscopic effect,pathological effect of patients compared with western medicine alone,and had good safety and low incidence of adverse reactions;Due to the large heterogeneity of outcome indicators with clinical symptom efficacy,HP negative conversion rate,it needs to be further verified by clinical high-quality randomized controlled trials.2.Based on the "traditional Chinese medicine inheritance computing platform",data mining was carried out on 45 documents included in the meta-analysis,and the following drug laws were obtained:Modern traditional Chinese medicine treats CAG mainly by supplementing qi and strengthening spleen,activating blood circulation and removing blood stasis.It is believed that the pathogenesis of CAG is spleen and stomach weakness.The treatment should be based on the spleen and stomach,taking into account the liver,lung and other viscera.The drugs are mainly used to replenish qi and strengthen the spleen.They are often combined with drugs such as activating blood circulation and removing stasis,clearing heat and removing dampness to achieve the purpose of treating both symptoms and symptoms,fully reflecting the characteristics of syndrome differentiation and treatment in traditional Chinese medicine.