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Abstract：
BACKGROUND: Currently, traditional Chinese medicine (TCM) formulas are commonly being used as adjunctive therapy for ulcerative colitis in China. Network meta-analysis, a quantitative and comprehensive analytical method, can systematically compare the effects of different adjunctive treatment options for ulcerative colitis, providing scientific evidence for clinical decision-making.
OBJECTIVE: To evaluate the clinical efficacy and safety of commonly used TCM for the treatment of ulcerative colitis (UC) in clinical practice through a network meta-analysis.
METHODS: Clinical randomized controlled trials of these TCM formulas used for the adjuvant treatment of UC were searched from the establishment of the databases to July 1, 2022. Studies that met the inclusion criteria were screened and evaluated for literature quality and risk of bias according to the Cochrane 5.1 standard. The methodological quality of the studies was assessed using ReviewManager (RevMan) 5.4, and a funnel plot was constructed to test for publication bias. ADDIS 1.16 statistical software was used to perform statistical analysis of the treatment measures and derive the network relationship and ranking diagrams of the various intervention measures.
RESULTS: A total of 64 randomized controlled trials involving 5456 patients with UC were included in this study. The adjuvant treatment of UC using five TCM formulations was able to improve the clinical outcome of the patients. Adjuvant treatment with Baitouweng decoction (BTWT) showed a significant effect [mean difference = 36.22, 95% confidence interval (CI): 7.63 to 65.76]. For the reduction of tumor necrosis factor in patients with UC, adjunctive therapy with BTWT (mean difference = -9.55, 95%CI: -17.89 to -1.41), Shenlingbaizhu powder [SLBZS; odds ratio (OR) = 0.19, 95%CI: 0.08 to 0.39], and Shaoyao decoction (OR = -23.02, 95%CI: -33.64 to -13.14) was effective. Shaoyao decoction was more effective than BTWT (OR = 0.12, 95%CI: 0.03 to 0.39), SLBZS (OR = 0.19, 95%CI: 0.08 to 0. 39), and Xi Lei powder (OR = 0.34, 95%CI: 0.13 to 0.81) in reducing tumor necrosis factor and the recurrence rate of UC.
CONCLUSIONS: TCM combined with mesalazine is more effective than mesalazine alone in the treatment of UC.
OBJECTIVE: To evaluate the clinical efficacy and safety of commonly used TCM for the treatment of ulcerative colitis (UC) in clinical practice through a network meta-analysis.
METHODS: Clinical randomized controlled trials of these TCM formulas used for the adjuvant treatment of UC were searched from the establishment of the databases to July 1, 2022. Studies that met the inclusion criteria were screened and evaluated for literature quality and risk of bias according to the Cochrane 5.1 standard. The methodological quality of the studies was assessed using ReviewManager (RevMan) 5.4, and a funnel plot was constructed to test for publication bias. ADDIS 1.16 statistical software was used to perform statistical analysis of the treatment measures and derive the network relationship and ranking diagrams of the various intervention measures.
RESULTS: A total of 64 randomized controlled trials involving 5456 patients with UC were included in this study. The adjuvant treatment of UC using five TCM formulations was able to improve the clinical outcome of the patients. Adjuvant treatment with Baitouweng decoction (BTWT) showed a significant effect [mean difference = 36.22, 95% confidence interval (CI): 7.63 to 65.76]. For the reduction of tumor necrosis factor in patients with UC, adjunctive therapy with BTWT (mean difference = -9.55, 95%CI: -17.89 to -1.41), Shenlingbaizhu powder [SLBZS; odds ratio (OR) = 0.19, 95%CI: 0.08 to 0.39], and Shaoyao decoction (OR = -23.02, 95%CI: -33.64 to -13.14) was effective. Shaoyao decoction was more effective than BTWT (OR = 0.12, 95%CI: 0.03 to 0.39), SLBZS (OR = 0.19, 95%CI: 0.08 to 0. 39), and Xi Lei powder (OR = 0.34, 95%CI: 0.13 to 0.81) in reducing tumor necrosis factor and the recurrence rate of UC.
CONCLUSIONS: TCM combined with mesalazine is more effective than mesalazine alone in the treatment of UC.
摘要：
背景：目前，在中国，传统中药（TCM）配方通常被用作溃疡性结肠炎的辅助疗法。网络荟萃分析，定量和全面的分析方法，可以系统地比较溃疡性结肠炎不同辅助治疗方案的效果，为临床决策提供科学依据。
目的：通过网络荟萃分析评价临床常用中医治疗溃疡性结肠炎(UC)的临床疗效和安全性。
方法：从数据库建立到2022年7月1日，检索这些中药方剂辅助治疗UC的临床随机对照试验。根据Cochrane5.1标准筛选并评估符合纳入标准的研究的文献质量和偏倚风险。使用ReviewManager（RevMan）5.4评估研究的方法学质量，并构建漏斗图以测试发表偏倚。采用ADDIS1.16统计软件对治疗措施进行统计分析，得出各种干预措施的网络关系和排序图。
结果：本研究共纳入64项随机对照试验，涉及5456例UC患者。使用五种中药配方辅助治疗UC能够改善患者的临床疗效。白头翁汤（BTWT）辅助治疗显着效果[平均差=36.22，95％置信区间（CI）：7.63至65.76]。对于降低UC患者的肿瘤坏死因子，BTWT辅助治疗（平均差异=-9.55，95CI：-17.89至-1.41），参灵白术散[SLBZS；优势比（OR）=0.19，95CI：0.08至0.39]，芍药汤（OR=-23.02，95CI：-33.64至-13.14）有效。芍药汤比BTWT更有效（OR=0.12，95CI：0.03至0.39），SLBZS(OR=0.19，95CI：0.08～0。39),与西雷散（OR=0.34，95CI：0.13～0.81）在降低肿瘤坏死因子和UC复发率方面有明显的相关性。
结论：中药联合美沙拉嗪治疗UC疗效优于单纯美沙拉嗪。
目的：通过网络荟萃分析评价临床常用中医治疗溃疡性结肠炎(UC)的临床疗效和安全性。
方法：从数据库建立到2022年7月1日，检索这些中药方剂辅助治疗UC的临床随机对照试验。根据Cochrane5.1标准筛选并评估符合纳入标准的研究的文献质量和偏倚风险。使用ReviewManager（RevMan）5.4评估研究的方法学质量，并构建漏斗图以测试发表偏倚。采用ADDIS1.16统计软件对治疗措施进行统计分析，得出各种干预措施的网络关系和排序图。
结果：本研究共纳入64项随机对照试验，涉及5456例UC患者。使用五种中药配方辅助治疗UC能够改善患者的临床疗效。白头翁汤（BTWT）辅助治疗显着效果[平均差=36.22，95％置信区间（CI）：7.63至65.76]。对于降低UC患者的肿瘤坏死因子，BTWT辅助治疗（平均差异=-9.55，95CI：-17.89至-1.41），参灵白术散[SLBZS；优势比（OR）=0.19，95CI：0.08至0.39]，芍药汤（OR=-23.02，95CI：-33.64至-13.14）有效。芍药汤比BTWT更有效（OR=0.12，95CI：0.03至0.39），SLBZS(OR=0.19，95CI：0.08～0。39),与西雷散（OR=0.34，95CI：0.13～0.81）在降低肿瘤坏死因子和UC复发率方面有明显的相关性。
结论：中药联合美沙拉嗪治疗UC疗效优于单纯美沙拉嗪。
