The pattern of disharmony between the liver and stomach is widely observed in patients with digestive diseases,such as gastroesophageal reflux disease,chronic gastritis,and functional dyspepsia,etc.In order to gain a ...The pattern of disharmony between the liver and stomach is widely observed in patients with digestive diseases,such as gastroesophageal reflux disease,chronic gastritis,and functional dyspepsia,etc.In order to gain a full and systematic understanding of this pattern,we reviewed the functions and physiological characteristics of the liver and stomach and the liver-stomach relationship.In this review,we discuss the pathogenesis and identification of the pattern,as well as the commonly used classical formulas for its treatment,including Left Metal Pill (Zuojin Wan) and Bupleurum Liver-Soothing Powder (Chaihu Shugan San).Besides,we provide two examples of clinical modifications of these formulas in the treatment of chronic gastritis and gastroesophageal reflux disease in this article.It should be noted that in clinical practice,these formulas should be used flexibly,and modified in accordance to the specific condition of the patient.展开更多
BACKGROUND Chronic gastritis(CG)is a common gastrointestinal disorder characterized by inflammation of the stomach lining.Liver-stomach disharmony(LSD)syndrome is believed to contribute to CG symptoms.AIM To evaluate ...BACKGROUND Chronic gastritis(CG)is a common gastrointestinal disorder characterized by inflammation of the stomach lining.Liver-stomach disharmony(LSD)syndrome is believed to contribute to CG symptoms.AIM To evaluate the efficacy and safety of microcosmic syndrome differentiation and Chinese herbal medicine(CHM)treatment in patients with CG and LSD syndrome.METHODS Sixty-four patients with CG and LSD syndrome were randomly divided into two groups:The treatment group received CHM based on microcosmic syndrome differentiation and the control group received conventional Western medicine.The treatment course lasted 12 wk.The primary outcome was improvement in dyspeptic symptoms,measured using the Nepean Dyspepsia Index.The secondary outcomes included the improvement rate of endoscopic findings,histopathological findings,and microcosmic syndrome scores and the incidence of adverse events.RESULTS After 12 wk of treatment,the treatment group showed significantly greater improvement in dyspeptic symptoms than the control group(93.75%vs 65.63%,P<0.01).The treatment group also showed a significantly higher improvement rate in endoscopic findings than the control group(81.25%vs 53.13%,P<0.05).The improvement rates of histopathological findings and microcosmic syndrome scores were not significantly different between the two groups(P>0.05).No serious adverse events were observed in either group.CONCLUSION Microcosmic syndrome differentiation and CHM treatment can effectively improve dyspeptic symptoms and endoscopic findings in patients with CG and LSD syndrome and have a good safety profile.Further studies with larger sample sizes and longer follow-up periods are required to confirm the long-term efficacy and mechanism of action of this treatment.展开更多
目的探究功能性消化不良的中医辨证分型及用药规律,为该病的中医治疗提供参考。方法检索中国知网(CNKI)、万方数据库(Wangfang)、维普数据库(VIP)、PubMed、Web of Science数据库中有关中医药治疗功能性消化不良的临床研究文献,收集中...目的探究功能性消化不良的中医辨证分型及用药规律,为该病的中医治疗提供参考。方法检索中国知网(CNKI)、万方数据库(Wangfang)、维普数据库(VIP)、PubMed、Web of Science数据库中有关中医药治疗功能性消化不良的临床研究文献,收集中药复方,建立数据库,使用Excel 2019、Clementine 12.0和SPSS 21.0对功能性消化不良的中医证型、中药使用频次、功效分类、性味归经进行频次统计,并对高频药物进行关联规则分析、因子分析和聚类分析。结果共纳入文献428篇,提取处方442首,涉及中药225味,高频药物24味,其中党参、茯苓、陈皮、柴胡的使用频次最多,功效分类以补虚药、理气药最为常见,药性以温为主,药味以苦、辛、甘为主,多归脾、肺、胃经;关联规则分析得到20种药物组合,因子分析提取了9个公因子,聚类分析可将药物分为4类。功能性消化不良肝胃不和证最多,对其进行关联规则分析得到12种药物组合,因子分析提取了3个公因子,聚类分析可将药物分为2类。结论中医临床治疗功能性消化不良以益气健脾、疏肝行气药为主,甘温补虚、辛开苦降,辨证配伍化湿、解表、清热等药物。展开更多
OBJECTIVE： To systematically assess the clinical ef- fectiveness of traditional Chinese medicine （TCM） in the treatment of functional dyspepsia （FD） of liv- er-stomach disharmony syndrome by meta-analysis. METHOD...OBJECTIVE： To systematically assess the clinical ef- fectiveness of traditional Chinese medicine （TCM） in the treatment of functional dyspepsia （FD） of liv- er-stomach disharmony syndrome by meta-analysis. METHODS： Random controlled trials （RCTs） were retrieved from databases, including Pubmed, China national knowledge infrastructure, Wanfang Data, VlP Information, and the Cochrane Library. Trials were selected according to inclusion criteria. The ef- fects of traditional Chinese medicine （TCM） versus prokinetic agents in the treatment of functional dyspepsia （FD） of liver-stomach disharmony syn- drome were compared by meta-analysis. RevMan 5.0.24 was used for data analysis. The effective rate was assessed by odds ratios （ORs）, and 95% confi- dence intervals （C＇/s） were calculated. The cure rate was analyzed by the Peto OR. Simple statistica~ anal- ysis was chosen to assess the frequency of pre- scribed Chinese herbs in treating this syndrome.RESULTS： Thirteen trials were included, involving 1153 patients, and these were of poor methodolog- ical quality. Twelve studies mentioned the effective rate and cure rate. TCM therapy showed a better clinical effect rate compared with that with proki- netic agents [OR： 3.2, 95% CI （2.27, 4.51）]. The TCM group also had a better cure rate than that in the group of prokinetic agents [Peto OR： 2.26, 95% CI （1.61, 3.18）]. With regard to the frequency of Chi- nese herbs used in these 13 trials, Baishao （Radix Paeoniae）, Chaihu （Radix Bupleuri）, and Gancao （Ra- dix Glycyrrhizae） were mostly prescribed, followed by Xiangfu （Rhizoma Cyperi）, Zhishi （Fructus Auran- tii Immaturus）, Zhiqiao （Fructus Aurantii）, Foshou （Citrus medica var.sarcodactylis）, and Chenpi （Peri- carpium Citri Reticulatae）. No serious adverse ef- fects were reported. CONCLUSION： TCM therapy shows a superior effec- tive rate and cure rate compared with those in pro- kinetic agents in the treatment of FD of liver-stom- ach disharmony syndrome. However, further strict- ly designed RCTs are required because of the poor quality of included trials.展开更多
文摘The pattern of disharmony between the liver and stomach is widely observed in patients with digestive diseases,such as gastroesophageal reflux disease,chronic gastritis,and functional dyspepsia,etc.In order to gain a full and systematic understanding of this pattern,we reviewed the functions and physiological characteristics of the liver and stomach and the liver-stomach relationship.In this review,we discuss the pathogenesis and identification of the pattern,as well as the commonly used classical formulas for its treatment,including Left Metal Pill (Zuojin Wan) and Bupleurum Liver-Soothing Powder (Chaihu Shugan San).Besides,we provide two examples of clinical modifications of these formulas in the treatment of chronic gastritis and gastroesophageal reflux disease in this article.It should be noted that in clinical practice,these formulas should be used flexibly,and modified in accordance to the specific condition of the patient.
文摘BACKGROUND Chronic gastritis(CG)is a common gastrointestinal disorder characterized by inflammation of the stomach lining.Liver-stomach disharmony(LSD)syndrome is believed to contribute to CG symptoms.AIM To evaluate the efficacy and safety of microcosmic syndrome differentiation and Chinese herbal medicine(CHM)treatment in patients with CG and LSD syndrome.METHODS Sixty-four patients with CG and LSD syndrome were randomly divided into two groups:The treatment group received CHM based on microcosmic syndrome differentiation and the control group received conventional Western medicine.The treatment course lasted 12 wk.The primary outcome was improvement in dyspeptic symptoms,measured using the Nepean Dyspepsia Index.The secondary outcomes included the improvement rate of endoscopic findings,histopathological findings,and microcosmic syndrome scores and the incidence of adverse events.RESULTS After 12 wk of treatment,the treatment group showed significantly greater improvement in dyspeptic symptoms than the control group(93.75%vs 65.63%,P<0.01).The treatment group also showed a significantly higher improvement rate in endoscopic findings than the control group(81.25%vs 53.13%,P<0.05).The improvement rates of histopathological findings and microcosmic syndrome scores were not significantly different between the two groups(P>0.05).No serious adverse events were observed in either group.CONCLUSION Microcosmic syndrome differentiation and CHM treatment can effectively improve dyspeptic symptoms and endoscopic findings in patients with CG and LSD syndrome and have a good safety profile.Further studies with larger sample sizes and longer follow-up periods are required to confirm the long-term efficacy and mechanism of action of this treatment.
基金Supported by Shenyang Municipal Program for Science and Technology 2011(F11-155-9-00)
文摘OBJECTIVE： To systematically assess the clinical ef- fectiveness of traditional Chinese medicine （TCM） in the treatment of functional dyspepsia （FD） of liv- er-stomach disharmony syndrome by meta-analysis. METHODS： Random controlled trials （RCTs） were retrieved from databases, including Pubmed, China national knowledge infrastructure, Wanfang Data, VlP Information, and the Cochrane Library. Trials were selected according to inclusion criteria. The ef- fects of traditional Chinese medicine （TCM） versus prokinetic agents in the treatment of functional dyspepsia （FD） of liver-stomach disharmony syn- drome were compared by meta-analysis. RevMan 5.0.24 was used for data analysis. The effective rate was assessed by odds ratios （ORs）, and 95% confi- dence intervals （C＇/s） were calculated. The cure rate was analyzed by the Peto OR. Simple statistica~ anal- ysis was chosen to assess the frequency of pre- scribed Chinese herbs in treating this syndrome.RESULTS： Thirteen trials were included, involving 1153 patients, and these were of poor methodolog- ical quality. Twelve studies mentioned the effective rate and cure rate. TCM therapy showed a better clinical effect rate compared with that with proki- netic agents [OR： 3.2, 95% CI （2.27, 4.51）]. The TCM group also had a better cure rate than that in the group of prokinetic agents [Peto OR： 2.26, 95% CI （1.61, 3.18）]. With regard to the frequency of Chi- nese herbs used in these 13 trials, Baishao （Radix Paeoniae）, Chaihu （Radix Bupleuri）, and Gancao （Ra- dix Glycyrrhizae） were mostly prescribed, followed by Xiangfu （Rhizoma Cyperi）, Zhishi （Fructus Auran- tii Immaturus）, Zhiqiao （Fructus Aurantii）, Foshou （Citrus medica var.sarcodactylis）, and Chenpi （Peri- carpium Citri Reticulatae）. No serious adverse ef- fects were reported. CONCLUSION： TCM therapy shows a superior effec- tive rate and cure rate compared with those in pro- kinetic agents in the treatment of FD of liver-stom- ach disharmony syndrome. However, further strict- ly designed RCTs are required because of the poor quality of included trials.
