氟哌噻吨美利曲辛联合其他药物治疗肠易激综合征疗效的Meta分析

Meta-analysis of the effect of flupentixol and melitracen combined with conventional medicine on irritablebowel syndrome

目的了解氟哌噻吨美利曲辛联合常规药物与单用常规药物治疗肠易激综合征（IBS）疗效的差异。方法检索中国期刊全文数据库、中国维普全文数据库、PubMed外文期刊数据库，检出氟哌噻吨美利曲辛联合其他常规药物（匹维溴铵及马来酸曲美布汀）与单用常规药物治疗IBS的研究进行比较分析，并在此基础上进行异质性检验和合并效应量的估计。结果共检出12项疗程为4-12周的氟哌噻吨美利曲辛联合其他常规药物治疗IBS的临床试验，其中6项研究提示氟哌噻吨美利曲辛联合匹维溴铵与单用匹维溴铵治疗比较，异质性检验X^2=1．90，自由度（df）=5，P=0．86，I^2=0，固定效应模型的合并比值比（OR）=7．92，95％CI（4．85，12．95），提示联合优于单药治疗；另6项研究提示氟哌噻吨美利曲辛联合马来酸曲美布汀与单用马来酸曲美布汀治疗比较，异质性检验X^2=5．60，df=5，P=0．35，I^2=10．6％，固定效应模型OR=5．91，95％CI（4．06，8．61），提示联合优于单药治疗。合并该12项研究提示氟哌噻吨美利曲辛联合其他常规药物与单用常规药物治疗比较，异质性检验X^2=8．40，df=11，P=0．68，r=0，固定效应模型OR=6．63，95％60CI（4．92，8．93）。结论氟哌噻吨美利曲辛联合其他药物治疗IBS的疗效优于单用其他常规药物，但仍需进一步高质量的研究验证。

Objective To evaluate the efficacy difference between flupentixol and melitracen combined with conventional medicine and conventional drug alone in the treatment of irritable bowel syndrome （IBS）. Methods Studies on flupentixol and melitracen combined with conventional medicine （pinaverium bromide and trimebutine maieate） and conventional medicine alone in the treatment of IBS were collected and reviewed through searching the Chinese Academic Journals Full-text Database, Chinese VIP Full-text Database and PubMed database. After that, the test for homogeneity and the combined effect test were estimated. Results A total of 12 clinical studies on flupentixol and melitracen combined with conventional medicine for four to twelve weeks in the treatment of IBS were collected six studies indicated the homogeneity test of flupentixol and melitracen combined with pinaverium bromide （X^2= 1.90, df= 5, P=0.86, I^2=0）. For the fixed-effect model, the odds ratio was 7.92 and 95% CI was between 4. 85 and 12. 95, which suggested the combined therapy was better. The other six studies indicated the homogeneity rest of flupentixol and melitracen combined with trimebutine maleate （X^2= 5.60, df= 5, P= 0.35, I^2 = 10.6% ）. For the fixed-effect model, theodds ratio was 5.91 and 95% CI was between 4.06 and 8.61, which suggested the combined therapy was better. After merging the 12 studies it indicated the homogeneity test of flupentixol and melitracen combined with conventional medicine （X^2=8. 40, df = 11, P = 0. 68, I^2 = 0）. For the fixed-effect model, the odds ratio was 6.63 and 95 %CI was between 4.92 and 8.93. Conclusion The efficacy of flupentixol and melitracen combined with conventional medicine in the treatment of IBS was better than that of conventional medicine alone, however, still more high quality trials are needed for further confirmation.