邹孟龙 黄晓燕 陈雅璐 宁芯

摘要 目的：评估四君子汤为基本方的方药治疗溃疡性结肠炎（UC）的疗效。方法：检索7个医学常用数据库，收集四君子汤治疗UC的随机对照试验，时限均为建库至2020年3月，然后对数据进行整理和分析。结果：共纳入22项研究，包括1 862例患者。Meta分析显示：与常规西药治疗比较，四君子汤为基本方的方药能提高内镜疗效（OR=3.76，95%CI为2.83～5.00，P<0.000 01）、中医证候疗效（OR=3.08，95%CI为1.21～7.87，P=0.02）;改善血清肿瘤坏死因子α表达（MD=-5.21，95%CI为-6.86～-3.56，P<0.000 01）、血清白细胞介素-33表达（MD=-1.10，95%CI为-1.28～-0.92，P<0.000 01）、血清超氧化物歧化酶表达（MD=107.64，95%CI为84.14～131.14，P<0.000 01）以及降低不良反应发生率（OR=0.37，95%CI为0.15～0.94，P=0.04）。结论：四君子汤为基本方的方药治疗溃疡性结肠炎可显著提高临床疗效，改善血清炎症介质、超氧化物歧化酶表达，且安全性高。

关键词 四君子汤;溃疡性结肠炎;Meta分析;系统评价;随机对照试验;肿瘤坏死因子α;白细胞介素-33;超氧化物歧化酶

Abstract Objective：To evaluate the efficacy of Sijunzi Decoction in the treatment of ulcerative colitis（UC）.Methods：A total of 7 commonly used medical databases were searched by computer，and the randomized controlled trials of Sijunzi Decoction in the treatment of UC were collected，all of which were built from March to March 2020，and then the data were collected and analyzed.Results：A total of 22 studies were included，including 1862 patients.The results of Meta analysis showed that compared with conventional Western medicine，the prescription with Sijunzi Decoction as the basic prescription could improve the curative effect of endoscope [（OR=3.76，95%CI（2.83 to 5.00），P<0.000 01] and the curative effect of traditional Chinese medicine symptoms [（OR=3.08，95%CI（1.21 to 7.87），P=0.02]，improve the expression of serum tumor necrosis factor-α [MD=-5.21，95%CI（-6.86 to -3.56），P<0.000 01]，the expression of serum interleukin-33 [MD=-1.10，95%CI（-1.28 to -0.92），P<0.000 01]，the expression of serum superoxide dismutase [MD=107.64，95%CI（84.14 to 131.14），P<0.000 01]，and reduce the incidence of adverse reactions [（OR=0.37，95%CI（0.15 to 0.94），P=0.04].Conclusion：Sijunzi Decoction as the basic prescription in the treatment of ulcerative colitis can significantly improve the clinical efficacy，improve the expression of serum inflammatory mediators and superoxide dismutase，and has high safety.

Keywords Sijunzi Decoction; Ulcerative colitis; Meta Analysis; Systematic review; Randomized controlled trial; Tumor necrosis factor α; Interleukin-33; Superoxide dismutase

中圖分类号：R256.33;R256.34;R259文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.24.010

溃疡性结肠炎（Ulcerative Colitis，UC）是一种慢性炎症性肠病，可从直肠到结肠近端引发不同程度的黏膜炎症，其特征是黏膜炎症性溃疡[1]。因此，肠黏膜的愈合是治疗UC的关键。西医药物治疗UC的疗效仍具有很大的局限[2]。UC在中医学可归属为“痢疾”“腹痛”等范畴，脾胃虚弱贯穿疾病全过程[3]。四君子汤是健脾益气的经典方药，由人参、白术、茯苓和炙甘草4味药组成。现代药理研究表明，四君子汤具有调节胃肠功能和促进胃肠黏膜修复的效用[4-6]。近年来不少学者研究也表明单用四君子汤或以四君子汤为基本方的方药与常规西药比较治疗UC效果令人更加满意。……