重用生白术治疗慢性便秘疗效及安全性的Meta分析
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摘要
目的系统评价重用生白术治疗慢性便秘的临床疗效和安全性。方法计算机检索中国生物医学文献数据库(CBM)、万方数据库、中国知网、维普数据库,检索截止日期为2016年9月。纳入有关重用生白术治疗慢性便秘的随机对照试验研究,并对符合纳入标准的文献资料,采用改良后的Jadad评分量表进行质量评分,采用Cochrane协作网提供的Rev Man5.3.0软件对临床总有效率进行Meta分析。结果共纳入符合标准20篇文献,总样本数1 874例,包括治疗组1 019例,对照组855例。所有纳入文献的Jadad评分均为1~3分,文献质量较低。Meta分析结果显示:重用生白术治疗慢性便秘临床总有效率高于对照组,差异有统计学意义[OR=4.34,95%CI(3.24,5.81),P<0.01]。在安全性方面,共7篇文献提及不良反应,两组不良反应类型和程度基本一致,均未出现严重不良反应。结论重用生白术治疗慢性便秘较其他对照治疗方法有较明显的临床疗效,且安全性尚可。但纳入文献质量较低,仍需更多高质量、大样本的随机对照实验的研究文献加以证实。
Objective To systematically evaluate the clinical curative effect of reuse of Atractylodes Macrocephala in treating chronic constipation. Methods Databases such as Chinese Biological and Medical Database, Wanfang Database, China National Knowledge Infrastructure and VIP Database, from the establishment of the databases to September of 2016. The randomized controlled trials on reuse of Atractylodes Macrocephala in treating chronic constipation were collected. Made quality evaluation of papers in accordance with the inclusive criteria by Jadad score method, make Meta analysis of the clinical effective rate with the software of Rev Man 5.3.0 from Cochrane Collaboration. Results Eventually twenty papers accorded with standard were included, a total of 1 874 patients including 1 019 patients of treatment group and 855 patients of control group. All researches were low in quality, whose Jadad scores were all 1~3. Meta analysis results showed that the clinical effective rate of reuse of Atractylodes Macrocephala in treating chronic constipation is higher than control group, exist statistical difference [OR=4.34, 95%CI(3.24, 5.81), P < 0.01]. ConclusionThe clinical curative effect of reuse of Atractylodes Macrocephala in treating chronic constipation was superior to other controlled therapeutic methods, both safe enough. But the included papers were relatively low in quality, more high quality and large sample size randomized controlled trials are needed to make a certain conclusion.
Objective To systematically evaluate the clinical curative effect of reuse of Atractylodes Macrocephala in treating chronic constipation. Methods Databases such as Chinese Biological and Medical Database, Wanfang Database, China National Knowledge Infrastructure and VIP Database, from the establishment of the databases to September of 2016. The randomized controlled trials on reuse of Atractylodes Macrocephala in treating chronic constipation were collected. Made quality evaluation of papers in accordance with the inclusive criteria by Jadad score method, make Meta analysis of the clinical effective rate with the software of Rev Man 5.3.0 from Cochrane Collaboration. Results Eventually twenty papers accorded with standard were included, a total of 1 874 patients including 1 019 patients of treatment group and 855 patients of control group. All researches were low in quality, whose Jadad scores were all 1~3. Meta analysis results showed that the clinical effective rate of reuse of Atractylodes Macrocephala in treating chronic constipation is higher than control group, exist statistical difference [OR=4.34, 95%CI(3.24, 5.81), P < 0.01]. ConclusionThe clinical curative effect of reuse of Atractylodes Macrocephala in treating chronic constipation was superior to other controlled therapeutic methods, both safe enough. But the included papers were relatively low in quality, more high quality and large sample size randomized controlled trials are needed to make a certain conclusion.
引文
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[2]中华医学会消化病学分会胃肠动力学组,中华医学会外科学分会结直肠肛门外科学组.中国慢性便秘诊治指南[J].胃肠病学,2013,18(10):605-612.
[3]Jadad A R,Moore R A,Carroll D,et al.Assessing the quality of reports of randomized clinical trials:Is blinding necessary[J].Controlled Clinical Trials,1996,17(1):1-12.
[4]郑雪平.白术治疗结肠慢传输型便秘的研究[D].南京中医药大学,2004.
[5]马慧萍,任宏颖.生白术治疗慢性传输型便秘的护理体会[J].新疆中医药,2013,31(03):75-76.
[6]魏志军,张悦,张小惠,等.重用生白术治疗虚证便秘的临床及实验研究[J].中国中医药科技,2003,10(04):196-197.
[7]侯毅,李悠然,王浩,等.大剂量生白术配伍枳实治疗成人功能性便秘疗效及安全性评价[J].世界华人消化杂志,2015,23(04):694-700.
[8]徐胜艳,胡响当,邵秋香.魏氏白术汤治疗慢传输型便秘45例[J].湖南中医杂志,2013,29(05):49-51.
[9]罗莉丽.白术调肠饮对慢性便秘的治疗效果分析[J].大家健康(学术版),2016,10(08):111.
[10]巩国峰.自拟白术通便汤治疗老年性便秘25例[J].云南中医中药杂志,2014,35(06):55.
[11]陈和.加味白术汤治疗虚秘型便秘58例疗效观察[J].广州中医药大学学报,2009,25(03):228-230.
[12]李超林.大剂量生白术合胃肠动力中药治疗老年性气虚型便秘65例[J].中医研究,2014,27(10):13-14.
[13]刘永,刘群,来要良,等.白术芪蓉汤治疗脾肾两虚型老年功能性便秘44例[J].环球中医药,2013,6(05):353-356.
[14]徐斌,王东宏,刘洁.生白术理气润肠合剂治疗慢传输型便秘(STC)36例临床观察[J].新疆中医药,2011,29(03):13-14.
[15]翁工清.自拟白术桃花汤治疗习惯性便秘临床观察[J].北京中医药大学学报(中医临床版),2003,10(02):21-23.
[16]徐蕴杰,徐文江,王宏侠.生白术三物汤治疗习惯性便秘65例临床观察[J].河北中医,2012,34(11):1636.
[17]李菊莲.生白术为主治疗习惯性便秘90例[J].江苏中医,2001,7(22):29.
[18]喻海农.白术调肠饮治疗老年便秘的临床研究[J].中外健康文摘,医药月刊,2008,5(4):50-51.
[19]张敏丽,石小翠.重用生白术塞因塞用治疗产后便秘36例[J].浙江中西医结合杂志,2013,23(7):566-567.
[20]沈毅,戴梅,张大炜.加味济川煎治疗慢性传输型便秘50例临床观察[J].北京中医药大学学报(中医临床版),2010,17(04):13-14.
[21]杨国汉,徐建众.重用生白术治疗老年功能性便秘42例-戴裕光教授治疗便秘经验的应用[J].中华现代中西医杂志,2003,1(9):817-818.
[22]张迎泉.白术调肠饮治疗慢性便秘的临床研究[D].山东中医药大学,2005.
[23]魏红.白术贞元饮治疗老年功能性便秘100例疗效观察[J].医学美学美容(中旬刊),2015,4(3):607-607.
[24]贺平,庞晓健.浅谈从脏腑治秘[A].中华中医药学会.中国肛肠病研究心得集[C].北京:中医古籍出版社,2011:437-438.
[2]中华医学会消化病学分会胃肠动力学组,中华医学会外科学分会结直肠肛门外科学组.中国慢性便秘诊治指南[J].胃肠病学,2013,18(10):605-612.
[3]Jadad A R,Moore R A,Carroll D,et al.Assessing the quality of reports of randomized clinical trials:Is blinding necessary[J].Controlled Clinical Trials,1996,17(1):1-12.
[4]郑雪平.白术治疗结肠慢传输型便秘的研究[D].南京中医药大学,2004.
[5]马慧萍,任宏颖.生白术治疗慢性传输型便秘的护理体会[J].新疆中医药,2013,31(03):75-76.
[6]魏志军,张悦,张小惠,等.重用生白术治疗虚证便秘的临床及实验研究[J].中国中医药科技,2003,10(04):196-197.
[7]侯毅,李悠然,王浩,等.大剂量生白术配伍枳实治疗成人功能性便秘疗效及安全性评价[J].世界华人消化杂志,2015,23(04):694-700.
[8]徐胜艳,胡响当,邵秋香.魏氏白术汤治疗慢传输型便秘45例[J].湖南中医杂志,2013,29(05):49-51.
[9]罗莉丽.白术调肠饮对慢性便秘的治疗效果分析[J].大家健康(学术版),2016,10(08):111.
[10]巩国峰.自拟白术通便汤治疗老年性便秘25例[J].云南中医中药杂志,2014,35(06):55.
[11]陈和.加味白术汤治疗虚秘型便秘58例疗效观察[J].广州中医药大学学报,2009,25(03):228-230.
[12]李超林.大剂量生白术合胃肠动力中药治疗老年性气虚型便秘65例[J].中医研究,2014,27(10):13-14.
[13]刘永,刘群,来要良,等.白术芪蓉汤治疗脾肾两虚型老年功能性便秘44例[J].环球中医药,2013,6(05):353-356.
[14]徐斌,王东宏,刘洁.生白术理气润肠合剂治疗慢传输型便秘(STC)36例临床观察[J].新疆中医药,2011,29(03):13-14.
[15]翁工清.自拟白术桃花汤治疗习惯性便秘临床观察[J].北京中医药大学学报(中医临床版),2003,10(02):21-23.
[16]徐蕴杰,徐文江,王宏侠.生白术三物汤治疗习惯性便秘65例临床观察[J].河北中医,2012,34(11):1636.
[17]李菊莲.生白术为主治疗习惯性便秘90例[J].江苏中医,2001,7(22):29.
[18]喻海农.白术调肠饮治疗老年便秘的临床研究[J].中外健康文摘,医药月刊,2008,5(4):50-51.
[19]张敏丽,石小翠.重用生白术塞因塞用治疗产后便秘36例[J].浙江中西医结合杂志,2013,23(7):566-567.
[20]沈毅,戴梅,张大炜.加味济川煎治疗慢性传输型便秘50例临床观察[J].北京中医药大学学报(中医临床版),2010,17(04):13-14.
[21]杨国汉,徐建众.重用生白术治疗老年功能性便秘42例-戴裕光教授治疗便秘经验的应用[J].中华现代中西医杂志,2003,1(9):817-818.
[22]张迎泉.白术调肠饮治疗慢性便秘的临床研究[D].山东中医药大学,2005.
[23]魏红.白术贞元饮治疗老年功能性便秘100例疗效观察[J].医学美学美容(中旬刊),2015,4(3):607-607.
[24]贺平,庞晓健.浅谈从脏腑治秘[A].中华中医药学会.中国肛肠病研究心得集[C].北京:中医古籍出版社,2011:437-438.