四逆散合痛泻要方与西药治疗肠易激综合征疗效系统评价

Evaluation on the therapeutic effect of Sini powder and Tongxieyao prescription and Western medicine on irritable bowel syndrome

关键词:  四逆散合痛泻要方  随机对照试验  方法学  质量评价

Key words:  Sini powder and Tongxieyao prescription  randomized controlled trial  methodology  quality evaluation

摘要:

[目的] 系统评价国内四逆散合痛泻要方治疗肠易激综合征的随机对照试验的疗效。[方法] 计算机检索 CNKI(2005-2015)、VIP(2005-2015)和WF(2005-2015)。辅以手工检索天津中医药大学图书馆过刊资料库。全面收集四逆散合痛泻要方的随机对照试验, 提取资料并按照Cochrane Reviewer's Handbook 5.0进行质量评估,统计学分析采用RevMan 5.2软件。[结果] 共纳入12个临床随机对照试验,合计1 778例患者。Meta分析结果显示:临床总有效率:合并效应量RR=1.30,其95%CI为(1.14,1.48),合并效应量的检验,Z=3.95,P<0.000 01。[结论] 四逆散合痛泻要方加减对照西药治疗肠易激综合征在临床总有效率方面有显著优势。但是,上述全部试验的结局指标,大多数直接采用简单的对比总有效率,而缺少症状积分评价,因此,在改善肠易激综合征患者具体症状,如腹痛、腹泻、排便急迫感、体倦乏力、纳呆等方面,四逆散合痛泻要方对照西药组的优势未全面、系统、直观的反映出来。由于纳入研究质量不高,上述结论尚需更多高质量的随机双盲对照试验加以验证。

Abstract:

[Objective] To evaluate on the therapeutic effect of Sini powder and Tongxieyao prescription and Western medicine on irritable bowel syndrome of randomized controlled trials. [Methods] By computer retrieval CNKI (2005-2015), VIP (2005-2015) and WF (2005-2015), supplemented by manual retrieval of Tianjin University of Chinese medicine library item database. Comprehensive collection of randomized controlled trials about Sini powder and Tongxieyao prescription, to extract information and according to the Cochrane Reviewer faced 5.0 quality assessment, statistical analysis by RevMan 5.2 software. [Results] 12 clinical randomized controlled trials were included, total 1 778 patients. Meta analysis showed: the clinical total effective rate: combined effects of RR=1.30, 95%CI (1.14, 1.48), merge effect quantity inspection, Z=3.95, P<0.000 01. [Conclusion] It has significant advantage of Sini powder and Tongxieyao prescription and Western medicine in the treatment of irritable bowel syndrome in clinical total effective rate. But, all of the above indexes, most directly using simple comparison of the total effective rate, and lack of symptoms integral evaluation, therefore, in improvement the symptoms of irritable bowel syndrome, such as abdominal pain, diarrhea, defecation urgency, body tired, anorexia, etc., it is not comprehensive, systematic, intuitive reflected of the advantage of comparison Sini powder and Tongxieyao prescription and Western medicine. Because the quality of included literature is not high, the above conclusion still needs more high-quality randomized, double-blind, placebo-controlled experiment to verify.