A meta-analysis of Banxia Xiexin decoction versus omeprazole in the treatment of gastroesophageal reflux disease

摘要

Objective:To investigate the clinical efficacy and safety of Banxia Xiexin decoction and omeprazole in the treatment of gastroesophageal reflux disease(GERD).Methods:EMbase,Cochrane,PubMed,CNKI,Wan Fang and VIP database were searched from inception to November 2018 according to the search strategy.Eligible randomized controlled clinical trials related to the efficacy of omeprazole compared with Banxia Xiexin decoction in the treatment of GERD were included according to the inclusion and exclusion criteria.Total effective rate,pathological improvement rate,total symptom score,acid reflux symptoms,heartburn symptoms,improvement of post-sternal pain symptoms,and incidence of adverse reactions were evaluated.Data analysis was performed with RevMan5.3 software provided by Cochrane Collaboration.Results:A total of 15 studies were enrolled,including 1,532 patients.Meta-analysis results showed that the total effective rate of Banxia Xiexinfang was higher than that of omeprazole in the treatment of GERD(odds ratio(OR)=3.99,95%confidence intervals(CI)(2.58,6.15),P<0.00001).Pathological improvement under endoscopy was not obvious(OR=1.98,95%CI(0.94,4.19),P=0.07)between the two groups.The total symptom score improved significantly,indicating that Banxia Xiexin decoction has an objective advantage over omeprazole in the treatment of GERD(standardised mean difference(SMD)=?2.56,95%CI(?3.86,?1.26),P=0.0001),The incidence of adverse reactions in patients treated with Banxia Xiexin decoction is lower than omeprazole group(OR=0.09,95%CI(0.02,0.39),P=0.001].In addition,total effective rate of Banxia Xiexin decoction combined with omeprazole was higher than omeprazole alone(OR=6.31,95%CI(2.86,13.92),P<0.00001).Conclusion:Banxia Xiexin decoction is superior to omeprazole in total effective rate,total symptom score and adverse reaction rate in the treatment of GERD.The clinical efficacy of Banxia Xiexin decoction combined with omeprazole is better than that of omeprazole alone.However,due to the low quality of the included literatures,large-scale and high-quality RCTs are still needed for further confirmation.