{"title":"格根秦连煎联合常规西药治疗感染性腹泻：系统回顾与试验序列分析》。","authors":"Fei Wang, Qianyan Wu, Qingyuan Zhang, Shuaishuai Ma, Kangyi Wang, Hui Jian, Ying Zhang","doi":"10.1159/000540793","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Infectious diarrhea (ID) is a highly prevalent disease worldwide that poses a substantial risk to human well-being. In China, numerous clinical studies have investigated the efficacy of Gegen Qinlian decoction (GGQLD) in treating ID. However, there is a need for additional rigorous and evidence-based medical research to enhance physicians' confidence in their prescribing practices.</p><p><strong>Methods: </strong>Seven Chinese and English databases were systematically searched. The Cochrane Risk of Bias tool was used to assess the quality of the included studies. Meta-analysis was conducted using RevMan 5.3, and Stata 16.0 was used for the sensitivity analysis. Trial sequential analysis was performed using TSA v0.9, and GRADEprofiler was utilized to evaluate the quality of evidence.</p><p><strong>Results: </strong>A total of 12 randomized controlled trials (RCTs) involving 1,240 patients were included. The meta-analysis demonstrated that the combination of GGQLD with conventional Western medicine had better effects on clinical efficacy (relative risk [RR] = 1.15, 95% confidence interval [CI] [1.10, 1.20]), duration of diarrhea symptoms (weighted mean difference [WMD] = -10.96, 95% CI [-11.97, -9.96]), duration of abdominal pain symptoms (WMD = -12.01, 95% CI [-14.12, -9.90]), duration of fever symptoms (WMD = -11.91, 95% CI [-13.39, -10.43]), interleukin-6 levels (WMD = -113.59, 95% CI [-113.03, -108.14]), and tumor necrosis factor-α levels (WMD = -62.18, 95% CI [-65.25, -59.11]) and that no significant adverse reactions occurred (RR = 0.45, 95% CI [0.10, 1.97]). The sample size of the included studies reached the expected size. The quality of evidence for outcome indicators was rated as low or very low.</p><p><strong>Conclusions: </strong>The combination of GGQLD with conventional Western medicine demonstrates promising efficacy and safety in treating ID. Nonetheless, more high-quality RCTs are required to confirm this conclusion.</p>","PeriodicalId":10541,"journal":{"name":"Complementary Medicine Research","volume":" ","pages":"461-476"},"PeriodicalIF":1.1000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Gegen Qinlian Decoction Combined with Conventional Western Medicine for the Treatment of Infectious Diarrhea: A Systematic Review and Trial Sequential Analysis.\",\"authors\":\"Fei Wang, Qianyan Wu, Qingyuan Zhang, Shuaishuai Ma, Kangyi Wang, Hui Jian, Ying Zhang\",\"doi\":\"10.1159/000540793\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Infectious diarrhea (ID) is a highly prevalent disease worldwide that poses a substantial risk to human well-being. In China, numerous clinical studies have investigated the efficacy of Gegen Qinlian decoction (GGQLD) in treating ID. However, there is a need for additional rigorous and evidence-based medical research to enhance physicians' confidence in their prescribing practices.</p><p><strong>Methods: </strong>Seven Chinese and English databases were systematically searched. The Cochrane Risk of Bias tool was used to assess the quality of the included studies. Meta-analysis was conducted using RevMan 5.3, and Stata 16.0 was used for the sensitivity analysis. Trial sequential analysis was performed using TSA v0.9, and GRADEprofiler was utilized to evaluate the quality of evidence.</p><p><strong>Results: </strong>A total of 12 randomized controlled trials (RCTs) involving 1,240 patients were included. The meta-analysis demonstrated that the combination of GGQLD with conventional Western medicine had better effects on clinical efficacy (relative risk [RR] = 1.15, 95% confidence interval [CI] [1.10, 1.20]), duration of diarrhea symptoms (weighted mean difference [WMD] = -10.96, 95% CI [-11.97, -9.96]), duration of abdominal pain symptoms (WMD = -12.01, 95% CI [-14.12, -9.90]), duration of fever symptoms (WMD = -11.91, 95% CI [-13.39, -10.43]), interleukin-6 levels (WMD = -113.59, 95% CI [-113.03, -108.14]), and tumor necrosis factor-α levels (WMD = -62.18, 95% CI [-65.25, -59.11]) and that no significant adverse reactions occurred (RR = 0.45, 95% CI [0.10, 1.97]). The sample size of the included studies reached the expected size. The quality of evidence for outcome indicators was rated as low or very low.</p><p><strong>Conclusions: </strong>The combination of GGQLD with conventional Western medicine demonstrates promising efficacy and safety in treating ID. 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引用次数: 0
摘要
背景：感染性腹泻（ID）是一种全球高发疾病，对人类健康构成了巨大威胁。在中国，许多临床研究都探讨了格根秦连煎（GGQLD）治疗感染性腹泻的疗效。然而，还需要更多严格的循证医学研究，以增强医生的处方信心：方法：系统检索了七个中英文数据库。方法：系统检索了 7 个中英文数据库，并使用 Cochrane Risk of Bias 工具评估纳入研究的质量。使用 RevMan 5.3 进行 Meta 分析，使用 Stata 16.0 进行敏感性分析。使用TSA v0.9进行试验序列分析，并使用GRADEprofiler评估证据质量：共纳入了 12 项随机对照试验（RCT），涉及 1240 名患者。荟萃分析表明，GGQLD与常规西药联合治疗在临床疗效（RR=1.15，95% CI [1.10，1.20]）、腹泻症状持续时间（WMD=-10.96，95% CI [-11.97，-9.96]）、腹痛症状持续时间（WMD=-12.01，95% CI [-14.12，-9.90]）、发热症状持续时间（WMD=-11.91，95% CI [-13.39，-10.43]）、白细胞介素-6（IL-6）水平（WMD=-113.59，95% CI [-113.03，-108.14]）和肿瘤坏死因子-α（TNF-α）水平（WMD=-62.18，95% CI[-65.25，-59.11]），且未出现明显的不良反应（RR = 0.45，95% CI [0.10，1.97]）。纳入研究的样本量达到了预期规模。结果指标的证据质量被评为低或很低：结论：GGQLD与传统西药联合治疗ID具有良好的疗效和安全性。尽管如此，还需要更多高质量的 RCT 研究来证实这一结论。
Gegen Qinlian Decoction Combined with Conventional Western Medicine for the Treatment of Infectious Diarrhea: A Systematic Review and Trial Sequential Analysis.
Introduction: Infectious diarrhea (ID) is a highly prevalent disease worldwide that poses a substantial risk to human well-being. In China, numerous clinical studies have investigated the efficacy of Gegen Qinlian decoction (GGQLD) in treating ID. However, there is a need for additional rigorous and evidence-based medical research to enhance physicians' confidence in their prescribing practices.
Methods: Seven Chinese and English databases were systematically searched. The Cochrane Risk of Bias tool was used to assess the quality of the included studies. Meta-analysis was conducted using RevMan 5.3, and Stata 16.0 was used for the sensitivity analysis. Trial sequential analysis was performed using TSA v0.9, and GRADEprofiler was utilized to evaluate the quality of evidence.
Results: A total of 12 randomized controlled trials (RCTs) involving 1,240 patients were included. The meta-analysis demonstrated that the combination of GGQLD with conventional Western medicine had better effects on clinical efficacy (relative risk [RR] = 1.15, 95% confidence interval [CI] [1.10, 1.20]), duration of diarrhea symptoms (weighted mean difference [WMD] = -10.96, 95% CI [-11.97, -9.96]), duration of abdominal pain symptoms (WMD = -12.01, 95% CI [-14.12, -9.90]), duration of fever symptoms (WMD = -11.91, 95% CI [-13.39, -10.43]), interleukin-6 levels (WMD = -113.59, 95% CI [-113.03, -108.14]), and tumor necrosis factor-α levels (WMD = -62.18, 95% CI [-65.25, -59.11]) and that no significant adverse reactions occurred (RR = 0.45, 95% CI [0.10, 1.97]). The sample size of the included studies reached the expected size. The quality of evidence for outcome indicators was rated as low or very low.
Conclusions: The combination of GGQLD with conventional Western medicine demonstrates promising efficacy and safety in treating ID. Nonetheless, more high-quality RCTs are required to confirm this conclusion.
期刊介绍：
Aims and Scope
''Complementary Medicine Research'' is an international journal that aims to bridge the gap between conventional medicine and complementary/alternative medicine (CAM) on a sound scientific basis, promoting their mutual integration. Accordingly, experts of both conventional medicine and CAM medicine cooperate on the journal‘s editorial board, which accepts papers only after a rigorous peer-review process in order to maintain a high standard of scientific quality.
Spectrum of ''Complementary Medicine Research'':
- Review and Original Articles, Case Reports and Essays regarding complementary practice and methods
- Journal Club: Analysis and discussion of internationally published articles in complementary medicine
- Editorials of leading experts in complementary medicine
- Questions of complementary patient-centered care
- Education in complementary medicine
- Reports on important meetings and conferences
- Society Bulletins of Schweizerische Medizinische Gesellschaft für Phytotherapie (SMGP) and Deutsche Gesellschaft für Naturheilkunde
Bibliographic Details
Complementary Medicine Research
Journal Abbreviation: Complement Med Res
ISSN: 2504-2092 (Print)
e-ISSN: 2504-2106 (Online)
DOI: 10.1159/issn.2504-2092
www.karger.com/CMR
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