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Efficacy and safety of Jianzhong decoction in treating peptic ulcers: a meta-analysis of 58 randomised controlled trials with 5192 patients

View Article: PubMed Central - PubMed

ABSTRACT

Background: Jianzhong decoction is widely used to treat peptic ulcers; however, due to lack of systematic evaluations, its clinical efficacy remains controversial. We performed meta-analysis to evaluate the efficacy and safety of Jianzhong decoction in treating peptic ulcers.

Methods: Studies were systematically retrieved from PubMed, Embase, Cochrane library, China National Knowledge Infrastructure, Wanfang Database, Chongqing VIP, China Biology Medicine disc (CBMdisc), and references cited in related studies/reviews. Extracted data included the total effective rate, helicobacter pylori eradication rates, recurrence rate, and adverse reaction rate. Fifty-eight randomised controlled trials involving 5192 patients were included in the final analysis.

Results: Results showed that Jianzhong decoction therapy was more effective than conventional Western medicine therapy (total effective rate, odds ratio [OR] = 4.29, 95% confidence interval [CI]: 3.51–5.23, P = 0.000; helicobacter pylori eradication rates, OR =2.10, 95% CI: 1.69–2.61, P = 0.000; recurrence rate, OR =0.23, 95% CI: 0.18–0.29, P = 0.000; and adverse reaction rate, OR =0.20, 95% CI: 0.12–0.33, P = 0.000).

Conclusions: Jianzhong decoction increased the total effective rate and helicobacter pylori eradication rate, and lowered the recurrence and adverse reaction rates. The results of this study can be used as a guide for clinical treatment of peptic ulcers.

Electronic supplementary material: The online version of this article (doi:10.1186/s12906-017-1723-2) contains supplementary material, which is available to authorized users.

No MeSH data available.


Inverted funnel plots of bias analysis on Hp eradication rates
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Fig7: Inverted funnel plots of bias analysis on Hp eradication rates

Mentions: We have analysed the publication bias of the aforementioned observation indicators and the results showed that the inverted funnel plots comparing the recurrence rate, Hp eradication rate, and adverse reactions were basically symmetrical as shown in Figs. 6, 7, and 8, respectively. The results of Egger’s test and Begg’s test also confirmed the absence of significant publication bias in those included studies: Hp eradication rate (Egger’s: P = 0.914; Begg’s: P = 0.785); recurrence rate (Egger’s: P = 0.213; Begg’s: P = 0.157); and adverse reaction rate (Egger’s: P = 0.518; Begg’s: P = 0.161). In contrast, the funnel plot comparing the total effective rate was asymmetrical, indicating the possible presence of publication bias in those included studies (Fig. 9). Moreover, the results of Egger’s and Begg’s tests also confirmed the presence of publication bias in those included studies reporting the total effective rate (Egger’s: P = 0.001; Begg’s: P = 0.202). The result robustness of the meta-analysis on the total effective rate was further analysed using the trim and filling method. After the addition of 15 false-negative unpublished studies, the results showed that the point estimation and 95% CI estimated value of the combined effect sizes did not change significantly before and after the clipping (before clipping: OR =4.06, 95% CI: 3.31–4.97, n = 47; after clipping: OR =3.29, 95% CI: 2.74–3.96, n = 62). This indicated that the meta-analysis on the total effective rate has a relatively better stability.Fig. 6


Efficacy and safety of Jianzhong decoction in treating peptic ulcers: a meta-analysis of 58 randomised controlled trials with 5192 patients
Inverted funnel plots of bias analysis on Hp eradication rates
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC5391578&req=5

Fig7: Inverted funnel plots of bias analysis on Hp eradication rates
Mentions: We have analysed the publication bias of the aforementioned observation indicators and the results showed that the inverted funnel plots comparing the recurrence rate, Hp eradication rate, and adverse reactions were basically symmetrical as shown in Figs. 6, 7, and 8, respectively. The results of Egger’s test and Begg’s test also confirmed the absence of significant publication bias in those included studies: Hp eradication rate (Egger’s: P = 0.914; Begg’s: P = 0.785); recurrence rate (Egger’s: P = 0.213; Begg’s: P = 0.157); and adverse reaction rate (Egger’s: P = 0.518; Begg’s: P = 0.161). In contrast, the funnel plot comparing the total effective rate was asymmetrical, indicating the possible presence of publication bias in those included studies (Fig. 9). Moreover, the results of Egger’s and Begg’s tests also confirmed the presence of publication bias in those included studies reporting the total effective rate (Egger’s: P = 0.001; Begg’s: P = 0.202). The result robustness of the meta-analysis on the total effective rate was further analysed using the trim and filling method. After the addition of 15 false-negative unpublished studies, the results showed that the point estimation and 95% CI estimated value of the combined effect sizes did not change significantly before and after the clipping (before clipping: OR =4.06, 95% CI: 3.31–4.97, n = 47; after clipping: OR =3.29, 95% CI: 2.74–3.96, n = 62). This indicated that the meta-analysis on the total effective rate has a relatively better stability.Fig. 6

View Article: PubMed Central - PubMed

ABSTRACT

Background: Jianzhong decoction is widely used to treat peptic ulcers; however, due to lack of systematic evaluations, its clinical efficacy remains controversial. We performed meta-analysis to evaluate the efficacy and safety of Jianzhong decoction in treating peptic ulcers.

Methods: Studies were systematically retrieved from PubMed, Embase, Cochrane library, China National Knowledge Infrastructure, Wanfang Database, Chongqing VIP, China Biology Medicine disc (CBMdisc), and references cited in related studies/reviews. Extracted data included the total effective rate, helicobacter pylori eradication rates, recurrence rate, and adverse reaction rate. Fifty-eight randomised controlled trials involving 5192 patients were included in the final analysis.

Results: Results showed that Jianzhong decoction therapy was more effective than conventional Western medicine therapy (total effective rate, odds ratio [OR] = 4.29, 95% confidence interval [CI]: 3.51–5.23, P = 0.000; helicobacter pylori eradication rates, OR =2.10, 95% CI: 1.69–2.61, P = 0.000; recurrence rate, OR =0.23, 95% CI: 0.18–0.29, P = 0.000; and adverse reaction rate, OR =0.20, 95% CI: 0.12–0.33, P = 0.000).

Conclusions: Jianzhong decoction increased the total effective rate and helicobacter pylori eradication rate, and lowered the recurrence and adverse reaction rates. The results of this study can be used as a guide for clinical treatment of peptic ulcers.

Electronic supplementary material: The online version of this article (doi:10.1186/s12906-017-1723-2) contains supplementary material, which is available to authorized users.

No MeSH data available.