乌梅丸及加减方治疗大肠疾病的系统评价再评价

Systematic review and re-evaluation of Wumei Pill and modified prescription in the treatment of colorectal diseases

关键词:  乌梅丸  大肠疾病  系统评价再评价  AMSTAR 2  PRISMA 2020  GRADE

Key words:  Wumei Pill  colorectal disease  systematic review and re-evalnation  AMSTAR 2  PRISMA 2020  GRADE

摘要:

[目的] 评价乌梅丸及加减方治疗大肠疾病的相关系统评价（SRs），为临床提供循证医学依据。[方法] 计算机检索PubMed、Cochrane Library、Embase、中国期刊全文数据库（CNKI）、维普中文期刊数据库（VIP）、万方数据知识服务平台（WanFang Data）和中国生物医学文献数据库（CBM），搜集乌梅丸及加减方治疗大肠疾病的SRs，检索时限为建库至2022年12月31日。两名研究者独立筛选文献、提取资料，分别采用AMSTAR 2、PRISMA 2020和GRADE评价纳入研究的方法学质量、报告质量及证据质量，并对结果进行综合分析。[结果] 共纳入12篇SRs，涉及4种疾病，有溃疡性结肠炎（UC）、肠易激综合征（IBS）、泄泻和大肠腺瘤性息肉术后。AMSTAR 2评价结果显示，10篇SRs为低质量，2篇SRs为极低质量；PRISMA 2020评分为19.5～30分，其中6篇SRs为中质量，6篇SRs为低质量。纳入SRs共报告了51个结局指标，GRADE评价结果为30个中质量，19个低质量，2个极低质量。现有证据显示，与常规治疗、空白对照/安慰剂相比，乌梅丸及加减方或联合常规治疗治疗UC、IBS、泄泻和大肠腺瘤性息肉术后的疗效更佳。[结论] 乌梅丸及加减方治疗大肠疾病具有较好的疗效，鉴于所纳入研究的样本量及疾病种类较少，其方法学质量、报告质量和证据质量相对较低，应慎重对待该结论，期待今后开展更多高质量研究证实。

Abstract:

[Objective] To overview the systematic reviews（SRs） of Wumei Pill and modified prescription in treating colorectal diseases，and provide evidence-based medical basis for clinic. [Methods] PubMed，Cochrane Library，Embase，CNKI，VIP，WanFang Data and CBM databases were searched to collect SRs of Wumei Pill and modified prescription for colorectal diseases from inception to December 31st，2022. Two reviewers independently screened literatures and extracted data. Then，AMSTAR 2，PRISMA 2020 and GRADE were used to assess the methodological quality，report quality and evidence quality of the included studies. The results of overview were analyzed in a comprehensive manner. [Results] A total of 12 SRs were included，involving 4 diseases，including ulcerative colitis（UC），irritable bowel syndrome（IBS），diarrhea and postoperative colorectal adenomatous polyps. And according to the AMSTAR 2 evaluation results，10 SRs were of low quality，and 2 SRs were of extremely low quality. PRISMA 2020 scores ranged from 19.5 to 30，of which 6 SRs were of medium quality and 6 SRs were of low quality. A total of 51 outcome indicators were reported by SRs，and the GRADE evaluation results showed that there were 30 medium quality，19 low quality and 2 extremely low quality. According to available evidence，as compared with routine treatment，no-treatment control or placebo，Wumei Pill and modified prescription or combined with routine treatment have better curative effect on UC，IBS，diarrhea and postoperative colorectal adenomatous polyps. [Conclusion] Wumei Pill and modified prescription have a good curative effect on colorectal diseases. As the methodological quality，report quality and evidence quality of the included studies are relatively low，this conclusion should be treated with caution and be confirmed by more high-quality studies in the future.