Meta AnalysisID 6401
九种中医治疗联合标准疗法治疗幽门螺杆菌阳性消化性溃疡：一项系统评价和贝叶斯网状Meta分析
CRD42021260037
How do different TCM therapies combined with standard treatment impact the efficacy and safety of helicobacter pylori-positive peptic ulcers compared with standard treatment?
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Record Fields
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- Meta Analysis Id
- 6401
- Evidence Id
- 14959
- Core Evidence Id
- 14959
- Source Meta Analysis Id
- 6385
- Herb2 Meta Analysis Id
- HBMA006385
- Crd Id
- CRD42021260037
- Title
- Nine TCM therapies with standard treatment for helicobacter pylori-positive peptic ulcers: A Systematic Review and Bayesian Network Meta-Analysis
- Review Question
- How do different TCM therapies combined with standard treatment impact the efficacy and safety of helicobacter pylori-positive peptic ulcers compared with standard treatment?
- Study Type Included
- Inclusion criteria: 1) Randomized controlled trials. 2) Literature in English or Chinese. Exclusion criteria: 1) Duplicate literature. 2) Researches on animals. 3) Retrospective study or non-randomized controlled trials. 4) The number of eligible studies for one intervention was no more than four.
- Condition Being Studied
- As we all know, helicobacter pylori, a bacterium, is responsible for 70%-85% of gastric ulcers and 90%-95% of duodenal ulcers. Also, many countries, such as China and Japan, have experienced an overall increase in the prevalence of HP infection over the last 20 years. Highly recommended by the clinical guidelines, triple therapy or quadruple therapy is the standard therapy for patients with HP-positive PU. Unfortunately, one problem is that the antimicrobial eradication rate of HP has been declining globally. Another concern for the standard therapy is that long-term PPI use inducing gastric hypochlorhydria and hypergastrinemia may harm the absorption of calcium, iron, magnesium, and vitamin B12 and may predispose to infection. Additionally, some studies have suggested an association between PPI use and community-acquired pneumonia, Clostridium difficile infection, and chronic kidney disease, among other conditions. From the perspective of bismuth, bismuth-containing quadruple therapy for HP eradication can lead to short-term gut microbiota dysbiosis. Increasing antimicrobial resistance, side effects, and falling eradication rates underline the importance of the updated guidelines on the management of HP. As a complementary therapy, traditional Chinese medicine adopts different therapeutic principles and prescriptions corresponding to different syndromes, which might help resolve antimicrobial resistance. The pharmaceutical studies illustrated several mechanisms of TCM in treating PU. For one thing, it inhibits the activity of gastric ulcer attack factors, varying from gastric acid, pepsin, gastrin to helicobacter pylori. For another, it upregulated protective factors of gastric mucosal, including the bicarbonate barrier in gastric mucus, the blood flow of gastric mucosal, and bioactive substances. Many kinds of TCM compounds have been widely used in clinical treatment but choosing which treatment seems challenging. According to the consensus on the diagnosis and treatment of peptic ulcers with integrated traditional Chinese and western medicine, many TCM therapies are highly recommended for clinical application. Apart from this, the previous meta-analysis of these therapies has proved efficacy and safety in some way, though the conclusion requires further verification. Nevertheless, there was no study to compare different TCM therapies with standard treatment. Therefore, we implemented a Bayesian network meta-analysis to find out the answer for clinical physicians.
- Participant
- Inclusion criteria: Adults diagnosed with HP-positive PU defined by consensus on diagnosis and treatment of peptic ulcer with Integrated traditional Chinese and Western Medicine (2017) without limitations on sex, race, region, or nationality. Exclusion criteria: Incongruent with the diagnosis.
- Animal
- Human Disease Modelled
- Intervention
- Inclusion criteria: Experimental groups received triple therapy or quadruple therapy combined with TCM (such as Chaihushugan powder, Weisu granule, Jianweiyuyang tablets) in either arm of treatment. Exclusion criteria: Experimental groups received only one kind of western medicine, such as PPI, or other TCM therapies were applied, such as acupuncture or massage.
- Comparator Control
- Inclusion criteria: Control groups receive triple therapy or quadruple therapy; A single application of western medicine is excluded. Exclusion criteria: Control groups received only one kind of western medicine, such as PPI.
- Main Outcome
- At least one of the following outcomes was assessed: endoscopic effective rate, HP eradication rate, incidence of adverse events, and recurrence rate. Measures of effect The risk ratio for dichotomous data and standard mean difference for continuous data.
- Outcome Measure
- Additional Outcome
- None.
- Study Method
- Network meta-analysis, Systematic review
- Keyword
- Bayes Theorem; Helicobacter Infections; Helicobacter pylori; Humans; Network Meta-Analysis; Peptic Ulcer
- Contact
- Nian Liu [email protected]
- Organisational Affiliation
- Clinical College of Traditional Chinese Medicine, Hubei University of Chinese Medicine
- Funding Source
- The current work was supported by the Wuhan Municipal Science and Technology Bureau of Applied Basic Research Project (no.2017060201010224).
- Other Selection Criteria
- Final Publication
- Same Topic Review
- Published Protocol
- Review Type
- Language
- English
- Country
- China
- Review Stage
- Review Ongoing
- First Submission Date
- 2021-06-09
- Registration Date
- 2021-07-10
- Anticipated Start Date
- 2021-06-01
- Anticipated Completion Date
- 2022-02-28
- Title Cn
- 九种中医治疗联合标准疗法治疗幽门螺杆菌阳性消化性溃疡：一项系统评价和贝叶斯网状Meta分析
- Title En
- Nine TCM therapies with standard treatment for helicobacter pylori-positive peptic ulcers: A Systematic Review and Bayesian Network Meta-Analysis
- Bilingual Status
- complete