天津中医药2026，Vol.43Issue(8)：988-999,12.DOI:10.11656/j.issn.1672-1519.2026.08.07
中成药胃复春联合西药对胃癌前病变的干预作用:一项系统评价与Meta分析
Chinese patent medicine Weifuchun combined with Western medicine for the intervention of gastric precancerous lesions:A systematic review and Meta-analysis
摘要
Abstract
[Objective]Gastric precancerous lesions are a pivotal stage in the occurrence and progression of gastric cancer,characterized by progressive core pathological changes including glandular atrophy,intestinal metaplasia,and dysplasia.Routine Western medicine can only relieve clinical symptoms such as upper abdominal discomfort in patients and control local inflammation,but has limited efficacy in reversing the above core pathological changes,which falls short of the clinical needs for halting the carcinogenic process.Chinese patent medicine Weifuchun is a commonly used Chinese patent medicine for the prevention and treatment of gastric precancerous lesions;however,existing studies are mostly single-center,small-sample randomized controlled trials(RCTs),with insufficient evidence grade and lack of systematic evaluation.[Methods]This study strictly followed the Cochrane Handbook for Systematic Reviews of Interventions and the PRISMA 2020 statement to conduct a systematic review.Chinese and English databases were systematically searched up to March 2026 to include RCTs comparing Chinese patent medicine Weifuchun combined with routine Western medicine versus the same regimen of Western medicine alone in the treatment of gastric precancerous lesions.Literature screening,data extraction and risk of bias assessment were independently completed by two researchers.Meta-analysis was performed using R software version 4.3.3.Sensitivity analysis,subgroup analysis and publication bias test were conducted for the primary outcomes.For outcome indicators with publication bias,the trim-and-fill method was further applied for correction to verify the robustness of the results.[Results]A total of 13 RCTs involving 1 394 patients were included.The results of Meta-analysis showed that Chinese patent medicine Weifuchun combined with Western medicine was significantly superior to Western medicine alone in improving glandular atrophy(SMD=-1.78,95%CI:-2.22 to-1.33,P<0.001)and intestinal metaplasia(SMD=-2.05,95%CI:-2.79 to-1.31,P<0.001).Two studies suggested that it also exerted an improving effect on dysplasia.Subgroup analysis showed that a treatment course of≥8 weeks had a more significant improvement effect on intestinal metaplasia.Publication bias test indicated that small sample effect existed in partial outcomes,and the results still maintained statistical significance after correction by the trim-and-fill method,which demonstrated that the conclusion of this study was robust and reliable.[Conclusion]Current evidence indicates that Chinese patent medicine Weifuchun combined with routine Western medicine can effectively intervene in gastric precancerous lesions.It can not only relieve clinical symptoms,but also reverse the core pathological changes of gastric precancerous lesions,which provides a safe and effective evidence-based basis for the integrated traditional Chinese and Western medicine prevention and treatment of this disease.However,affected by the limitations of the included studies(such as small sample size and mainly single-center studies),the conclusion of this study still needs to be further verified by more large-sample,multi-center,high-quality RCTs with longer follow-up duration.关键词
胃复春/胃癌前病变/腺体萎缩/肠上皮化生/异型增生/Meta分析/中西医结合疗法Key words
Weifuchun/gastric precancerous lesions/glandular atrophy/intestinal metaplasia/dysplasia/Meta-analysis/integrated traditional Chinese and Western medicine therapy分类
医药卫生引用本文复制引用
程宁涛,杨博文,张依族,熊可,张明妍,王佳宝,李慧臻,黄明..中成药胃复春联合西药对胃癌前病变的干预作用:一项系统评价与Meta分析[J].天津中医药,2026,43(8):988-999,12.基金项目
国家自然科学基金面上项目(82274442) （82274442）
第四届国医大师工作室项目. （）
