摘要
【目的】系统评价以乌梅丸为基本方治疗肠易激综合征(irritable bowel syndrome,IBS)的临床疗效及安全性。【方法】计算机检索中国知网(CNKI)、维普(VIP)、万方(Wanfang)、PubMed、the Cochrane library及Embase数据库中以乌梅丸(汤)为基本方治疗肠易激综合征的随机对照试验(RCTs)。由两位研究者独立对文献进行筛选及数据提取。采用Cochrane Reviewer’s Handbook推荐的质量评价工具对纳入文献进行质量评价,运用RevMan5.3软件对纳入文献进行Meta分析。【结果】共纳入13篇RCT文献,包含1 029例患者。Meta分析结果显示:与常规西药组比较,以乌梅丸(汤)为基本方的中药单用或联合常规西药能提高肠易激综合征患者临床疗效(总有效率OR=3.28,95%CI[2.25,4.79],P <0.000 01;治愈率OR=2.42,95%CI[1.75,3.34],P <0.000 01),降低复发率(OR=0.21,95%CI[0.11,0.41],P <0.000 01),降低血浆P物质水平(MD=15.33,95%CI[12.55,18.11],P <0.000 01);2组不良事件发生率比较差异无统计学意义(P> 0.05)。【结论】以乌梅丸为基本方治疗肠易激综合征有明显疗效;但因纳入试验存在一定发表偏倚且方法学质量偏低,故结论仍需多中心、大样本、高质量的随机对照试验予以进一步验证。
Objective To systematically evaluate the clinical efficacy and safety of Wumei Pills as the basic prescription in treating irrritable bowel syndrome(IBS). Methods We collected randomized controlled trials(RCTs)of Wumei Pills(Decoction)in treating IBS from CNKI,VIP database,Wanfang database,PubMed,the Cochrance library,and Embase by computer retrieval. The screening of RCTs and the data extract were performed by two researchers independently. The quality of the included trials was evaluated with the Cochrane Reviewer’s Handbook for systematic review,and RevMan 5.3 software was adopted to perform Meta-analysis. Results A total of 13 RCTs involving 1 029 IBS patients were included in the analysis. The results of Meta-analysis showed that Wumei Pills as the basic prescription alone or combined with routine western medicine in treating IBS could enhance the therapeutic efficacy(total effective rate:OR = 3.28,95%CI[2.25,4.79],P < 0.000 01;cure rate:OR = 2.42,95%CI[1.75,3.34],P < 0.000 01),reduce the recurrence rate(OR = 0.21,95%CI[0.11,0.41],P < 0.000 01),and decrease the plasma substance P level(MD = 15.33,95%CI[12.55,18.11],P < 0.000 01).The difference of the incidence of adverse events in the two groups was not statistically significant(P > 0.05).Conclusion Wumei Pills as the basic prescription have obvious effect for the treatment of IBS. However,due to the possible publication bias and the low methodological quality of included studied,the above conclusion still need to be further verified with multi-center,large-sample and high-quality RCTs.
作者
陈秒旬
郑耿东
陈瑞芳
CHEN Miao-Xun;ZHENG Geng-Dong;CHEN Rui-Fang(Guangzhou University of Chinese Medicine, Guangzhou 510006 Guangdong, China;The First AffiliatedHospital of Guangzhou University of Chinese Medicine, Guangzhou 510405 Guangdong, China)
出处
《广州中医药大学学报》
CAS
2019年第5期758-765,共8页
Journal of Guangzhou University of Traditional Chinese Medicine
关键词
乌梅丸
肠易激综合征
随机对照试验
META分析
Wumei Pills
irritable bowel syndrome
randomized controlled trials
Meta-analysis
