美常安治疗肠易激综合征的Meta分析

Meta-analysis of Medilac for Patients with IBS

目的:评价美常安治疗肠易激综合征的疗效及安全性。方法:计算机检索Cochrane图书馆(2011年第2期)、EMBASE、PubMed、中国期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、中文科技期刊全文数据库(VIP)关于美常安治疗肠易激综合征的随机对照试验。各数据库检索时间均从创建至2011年8月。由2名研究员按纳入与排除标准独立筛选试验,并对纳入研究的方法学质量进行评价,提取资料;用RevMan5.12软件对数据进行Meta分析。结果:共纳入15个随机对照试验,共1152名患者。美常安组总有效率优于对照组[RR=1.19,95%C(I1.08,1.32),P=0.0005],症状评分改善优于对照组[MD=1.83,95%CI(1.04,2.63),P<0.00001]。美常安组与对照组在腹痛症状改善[RR=1.07,95%CI(0.89,1.29),P=0.46]、腹泻症状改善[RR=1.08,95%CI(0.96,1.21),P=0.21]、不良反应发生率[OR=1.27,95%C(I0.68,2.37),P=0.46]方面差异无统计学意义。结论:基于现有临床证据,美常安治疗肠易激综合征有效、安全性好。但由于纳入研究数量较少,研究质量参差不齐,本结论尚需要更多大样本、高质量的临床随机对照试验予以证实。

OBJECTIVE：To evaluate the effectiveness and safety of Medilac for patients with IBS systematically.METHODS：We searched the Cochrane Library（Issue 2,2011）,EMBASE,PubMed,CBM,CNKI and VIP（from their inception to August 2011） for RCTs about Medilac for patients with IBS.Two reviewers independently retrieved RCTs according to the inclusion and exclusion criteria,assessed the methodological quality of included trials,and extracted data.The data analysis was performed by RevMan 5.12 software.RESULTS：15 RCTs involving 1 152 patients were ultimately included.The results of Meta-analysis showed that total effective rate of Medilac group was superior to control group [RR=1.19,95%CI（1.08,1.32）,P=0.000 5],and improvement of symptom score of Medilac group was superior to control group [MD=1.83,95%CI（1.04,2.63）,P0.000 01].There was no significant difference in improvement of abdominal pain [RR=1.07,95%CI（0.89,1.29）,P=0.46],improvement of diarrhea [RR=1.08,95%CI（0.96,1.21）,P=0.21],incidence of adverse drug reactions [OR=1.27,95%CI（0.68,2.37）,P=0.46] between two groups.CONCLUSIONS：Recent clinical basis indicate that Medilac for patients with IBS is effective and has good safety.Howerver,due to the number and quality of included studies,more large sample size,high-quality RCTs are needed.