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만성 위염에 대한 이중탕(理中湯)의 효과 : 체계적 문헌 고찰 및 메타 분석

The Effect of Yijung-tang for Chronic Gastritis: A Systemic Review and Meta-Analysis

이영서|김경민|진명호|김예슬
대한한방내과학회 (The Society Of Korean Oriental Internal Medicine)|2023.09|대한한방내과학회지 (The Journal of Korean Oriental Internal Medicine)|제44권 제4호|pp. 675-702

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meta-analysisYijung-tangChronic gastritisLizhong
주제분류한의학

초록

Objective: This study assessed the effectiveness of using Yijung-tang to treat chronic gastritis through a systematic review and meta-analysis of randomized controlled trials (RCTs). Methods: The search was conducted using keywords such as “gastritis”, “Lizhong”, “Yijung”, and “Chronic gastritis” on July 31, 2023. A meta-analysis was conducted according to outcome measurements, such as total effective rate (TER), Traditional chinese medicine symptom score (TSS), gastric hormones, and symptom relief time, using the Review Manager website. Results: A total of 11 RCT studies were selected. The treatment group (Yijung-tang-gagam or Yijung-tang-gagam+ Western medicine) showed significant improvement effects in terms of TER, TSS, serum gastrointestinal hormones (motilin (MTL), gastrin (GAS), and somatostatin (SS)), and symptom relief time compared to the control group (Western medicine). TER-RR : 1.20, 95% CI : 1.11 to 1.30, P≤0.00001, RR : 1.21, 95% CI : 1.14 to 1.28, P≤0.00001; MTL-MD : 35.99, 95% CI : 30.79 to 41.20, P≤0.00001); GAS-MD : 103.33, 95% CI : 97.62 to 109.04, P≤0.00001); SS : MD : -37.19, 95% CI : -41.75 to -32.64, P≤0.00001; symptom relief time (nausea)-MD : -1.96, 95% CI : -2.47 to -1.45, P≤0.00001; symptom relief time (colic)-MD : -1.75, 95% CI : -2.31 to -1.18, P≤0.00001. Conclusion: This study suggests that Yijung-tang is effective against chronic gastritis. However, the number of studies was insufficient, and the diagnosis and evaluation criteria were not standardized. Furthermore, because of the low quality of the included studies, more clinical studies need to be conducted to increase the possibility of clinical use.

Abstract

Objective: This study assessed the effectiveness of using Yijung-tang to treat chronic gastritis through a systematic review and meta-analysis of randomized controlled trials (RCTs). Methods: The search was conducted using keywords such as “gastritis”, “Lizhong”, “Yijung”, and “Chronic gastritis” on July 31, 2023. A meta-analysis was conducted according to outcome measurements, such as total effective rate (TER), Traditional chinese medicine symptom score (TSS), gastric hormones, and symptom relief time, using the Review Manager website. Results: A total of 11 RCT studies were selected. The treatment group (Yijung-tang-gagam or Yijung-tang-gagam+ Western medicine) showed significant improvement effects in terms of TER, TSS, serum gastrointestinal hormones (motilin (MTL), gastrin (GAS), and somatostatin (SS)), and symptom relief time compared to the control group (Western medicine). TER-RR : 1.20, 95% CI : 1.11 to 1.30, P≤0.00001, RR : 1.21, 95% CI : 1.14 to 1.28, P≤0.00001; MTL-MD : 35.99, 95% CI : 30.79 to 41.20, P≤0.00001); GAS-MD : 103.33, 95% CI : 97.62 to 109.04, P≤0.00001); SS : MD : -37.19, 95% CI : -41.75 to -32.64, P≤0.00001; symptom relief time (nausea)-MD : -1.96, 95% CI : -2.47 to -1.45, P≤0.00001; symptom relief time (colic)-MD : -1.75, 95% CI : -2.31 to -1.18, P≤0.00001. Conclusion: This study suggests that Yijung-tang is effective against chronic gastritis. However, the number of studies was insufficient, and the diagnosis and evaluation criteria were not standardized. Furthermore, because of the low quality of the included studies, more clinical studies need to be conducted to increase the possibility of clinical use.

참고문헌 (51)

  1. 이현우, "만성 위염의 내시경적 진단에 대한 조사", Korean Journal of Helicobacter Upper Gastrointestinal Research, 14(3), pp.194~198 (2014), 대한상부위장관ㆍ헬리코박터학회[DOI]
  2. Yang SY, "Prevalence of gastroesophageal reflux disease symptoms and uninvestigated dyspepsia in Korea : a population-based study", Dig Dis Sci, 53(1), pp.188~193 (2008)
  3. Fang JY, "Consensus on standard management of choronic gastritis in China", Chinese Journal of Gastroenterology, 18(01), pp.24~36 (2013)
  4. 임성균, "위염 분류의 역사적 배경", Korean Journal of Helicobacter Upper Gastrointestinal Research, 23(2), pp.84~88 (2023), 대한상부위장관ㆍ헬리코박터학회
  5. Kim YI, "Association between chronic gastritis and gastric cancer : A multicenter retrospective cohort study", J Gastroenterol Hepatol, 34(3), pp.544~551 (2019)
  6. 김인규, "위염치료제의 임상시험평가지침 연구", 약 학 회 지, 55(4), pp.345~351 (2011), 대한약학회
  7. Fang JY, "Consensus on standard management of choronic gastritis in china", Chin J Gastroenterology, 18(1), pp.24~36 (2013)
  8. Ko MG, "Hyundae-Sanghanron", pp.647~649 (2000), Haneuimunhwasa
  9. Hur J, "Donguibogam", pp.382~ (2007), Namsandang
  10. College of Oriental Medicine, Professors of Prescriptionology, "Prescriptionology", pp.232~233 (2003), Yeongrimsa
  11. 서창섭, "LC-MS", MS를 이용한 理中湯의 정량분석 및 항산화 활성, 2013, pp.21(1), 177~185[DOI]
  12. Shin IS, "Gastroprotective effects of Leejung-tang, an oriental traditional herbal formula, on ethanol-induced acute gastric injury in rats", African journal of traditional, complementary, and alternative medicines, 10(2), pp.324~330 (2013)
  13. 서희연, "理中湯이 IgE가 과잉생성되고 피부염이 유발된 NC", Nga생쥐에서 IFN-γ 반응에 의한 Th2 세포분화 억제에 미치는 영향, 2009, pp.23(1), 1~22[DOI]
  14. 서희연, "理中湯이 Mite antigen으로 유발된 NC", Nga 생쥐의 아토피 피부염에 미치는 영향, 2011, pp.25(1), 1~27[DOI]
  15. Koh KS, "Studies on the effects of aqua-acupuncture with Yi-Jung-tang extracts on the analgesia, anti-laxative and uropepsin value", J Korean Oriental Med, 5(1), pp.62~71 (1984)
  16. 이진아, "한약 처방 25종에 대한 항염증 효능 비교 연구", 대한한방부인과학회지, 23(3), pp.101~111 (2010), 대한한방부인과학회
  17. 이준영, "메타분석", Endocrinology and Metabolism, 23(6), pp.361~378 (2008), 대한내분비학회
  18. Ming XU, "Clinical Effect Research of Modified Center-Rectifying Decoction on with Spleen and Stomach Asthenia of Chronic Gastritis", Smart Healthcare, 9(1), pp.182~185 (2023)
  19. Chen Q, "Clinical Effect and Incidence of Adverse Reactions of Lizhong Decoction in the Treatment of Chronic Gastritis with Spleen Stomach Weakness(Cold)", Chinese and Foreign Medical Research, 19(6), pp.102~104 (2021)
  20. Duan D, "Clinical effects of the Lizhong decoction on spleen and stomach weakness syndrome of chronic gastritis", Clinical Journal of Chinese Medicine, 13(5), pp.48~51 (2021)
  21. 张川, "理中汤加减方治疗慢性胃炎(脾胃虚寒证)的临床疗效", 内蒙古中医药, 39(12), pp.14~15 (2020)
  22. Wei JT, "Observation on effect of lizhong decoction in treating chronic gastritis with spleen-stomach deficiency syndrome", Journal of Shandong Medical College, 42(2), pp.93~94 (2020)
  23. Ding M, "Effect experience of modified Lizhong decoction in treating syndrome of spleen and stomach weakness(cold)in chronic gastritis", Chinese community doctors, 34(25), pp.91~92 (2018)
  24. Qu F, "Clinical Observation on Modified Lizhong Decoction in the Treatment of Spleen and Stomach Deficiency-cold Syndrome of Chronic Gastritis", Guangmei traditional Chinese medicine, 34(7), pp.1036~1038 (2019)
  25. 杨录兴, "理中汤加减治疗慢性胃炎脾胃虚弱(寒)证的临床效果", 内蒙古中医药, 40(10), pp.38~39 (2021)
  26. 陈妍嫣, "理中汤加减治疗慢性胃炎脾胃虚弱(寒)证的临床效果观察", 医学食疗与健康, 18(11), pp.35~37 (2020)
  27. 姚春和, "理中汤加味联合替普瑞酮胶囊治疗慢性萎缩性胃炎的疗效及对血浆生长抑素, 胃泌素含量水平的影响", 四川中医, 35(12), pp.117~120 (2017)
  28. Shen S, "Clinical Efficacy of Lizhong Tang Combined with Western Medicine for Treating Chronic Gastritis with Spleen and Stomach Deficiency Type", Information on Traditional Chinese Medicine, 32(5), pp.101~103 (2015)
  29. Zhang S, "Expert consensus opinion on the diagnosis and treatment of chronic gastritis with traditional Chinese medicine(2017)", Chinese Journal of Traditional Chinese Medicine, 32(7), pp.3060~3064 (2017)
  30. Fang JY, "Chinese consensus opinion on chronic gastritis", Chinese Journal of Gastroenterology, 18(1), pp.24~36 (2013)
  31. 罗仁, "中医内科学", pp.36~ (2012), 科学出版社
  32. Liang MX, "An analysis on logical problems of zang-fu viscera syndromes in “Guidance principle of clinical study on new drug of traditional Chinese medicine"", China Journal of Traditional Chinese Medicine and Pharmacy, 14(5), pp.330~342 (2008)
  33. Tang XD, "Guidelines for Diagnosis and Treatment of Chronic Gastritis", Chinese Medicine Modern Distance Education of China, 09(10), pp.123~125 (2011)
  34. Feng SJ, "Clinical Observation on Chinese Medicine in Treating Chronic Gastritis of Deficiency of Spleen and Stomach", Guangmei traditional Chinese medicine, 33(15), pp.2148~2150 (2018)
  35. Shim SG, "Mechanisms of Motilin Action on Smooth Muscle of the Human Stomach", The Korean journal of gastroenterology, 39(1), pp.4~12 (2002)
  36. Norman AW, "Hormones" (1987), Academic press
  37. Sgouros SN, "Somatostatin and its analogues in peptic ulcer bleeding : facts and pathophysiological aspects", Dig Liver Dis, 38(2), pp.143~148 (2006)
  38. Perkins DJ, "Tumor necrosis factoralpha promotes sustained cyclooxygenase-2expression : attenuation by dexamethasone and NSAIDs", Prostaglandins, 54(4), pp.727~743 (1997)
  39. McCarty M, "Historical perspective on C-reactive protein", AnnN Y Acad Sci, 389, pp.1~10 (1982)
  40. Thelen M, "Mechanism of neutrophil activation by NAF, a novel monocyte-derived peptide agonist", FASEB J, 2(11), pp.2702~2706 (1988)
  41. Park HK, "The distribution of endoscopic gastritis in 23, 536 health check-up subjects in Korea", The Korean Journal of Helicobacter and Upper Gastrointestinal Research, 12(4), pp.237~243 (2012)
  42. Korean Society of Gastrointestinal Endoscopy, "Atlas of gastrointestinal endoscopy", pp.99~102 (2010), Daehan Medical Books
  43. Zendehdel N, "Helicobacter pylori reinfection rate 3 years after successful eradication", J Gastroenterol Hepatol, 20(3), pp.401~404 (2005)
  44. 박미선, "한국표준질병 사인분류에 따른 胃炎의 한의학적 변증 연구", 동의생리병리학회지, 31(5), pp.255~263 (2017), 한의병리학회[DOI]
  45. 유병국, "국내 한의학 학술지에 발표된 항염증 한약재 및 한약처방 연구동향 - 2015년 이후 발표된 실험논문을 중심으로 -", 대한본초학회지, 36(1), pp.19~39 (2021), 대한본초학회
  46. 오희경, "백출 용매추출 방법에 따른 항산화 활성 및 항염증 효과", 한국응용과학기술학회지, 38(6), pp.1543~1552 (2021), 한국응용과학기술학회
  47. 김호철, "한약약리학", pp.422~427 (2001), 집문당
  48. Andrea TB, "Shosaikoto and other Kampo(Japanese herbal)medicines : a review of their immunomodulatory activities", J Ethnopharmacol, 73(1-2), pp.1~13 (2000)
  49. Ahn HR, "The Ameliorating Effect of Lizhong-Tang on Antibiotic-Associated Imbalance in the Gut Microbiota in Mouse", Applied Sciences, 12(14), pp.6943~ (2022)
  50. 양정필, "‘중국인삼’의 실체에 대한 비판적 고찰- 이마무라 토모(今村革丙)의 학설을 중심으로 -", 의사학, 12(2), pp.4~166 (2003), 대한의사학회
  51. Higgins JP, "Cochrane handbook for systematic reviews of interventions. Ver. 5.1.0", The Cochrane Collaboration, ~ (2011)

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