中药治疗迁延性腹泻随机对照试验Meta-分析

Meta-Analysis on Randomize-Controlled Trials of Persistent Diarrhea Treated by Chinese Medicine

目的:用Meta-分析方法评价中药治疗迁延性腹泻的疗效和安全性。方法:计算机检索PubMed、Cochrane library、中国学术期刊全文数据库(CNKI)、中文科技期刊全文数据库(VIP)、万方数据资源系统(WangFang Data)数据库,收集中药治疗迁延性腹泻的随机对照试验。采用Cochrane协作网的质量评价标准并用其提供的软件RevMan5.0,对纳入试验的临床总有效率及不良反应进行统计分析。结果:共计纳入29篇随机对照试验治疗3028名患者。所纳入的文献质量普遍偏低。23个中药内服与西药治疗比较的试验中有20个研究结果显示试验组疗效优于对照组,3个研究显示两组统计结果差异无统计学意义;5个中药外治与西药治疗比较的试验中有4个研究结果显示试验组疗效优于对照组,1个研究显示两组结果无统计学意义。从干预措施整体比较,中药内服或中药外治治疗迁延性腹泻临床总有效率优于西药治疗。中药内服治疗未发现明显不良反应,中药外治出现皮肤红色丘疹。结论:中药治疗迁延性腹泻具有较好的疗效,但方法学方面亟待提高。

Objective ： To evaluate the effect and safety of Chinese medicine for persistent diarrhea with the method of Meta-analysis. Methods ： The following databases such as Pubmed, Cochrane library, CNKI, VIP, and WangFang Data were searched to collect the randomized controlled trials （ RCTs ）on Chinese medicine for persistent diarrhea.The quality evaluation standard of Cochrane Collaboration was adopted and the software RevMan 5.0 was used for the statistical analysis of the clinical total effective rate and untoward reactions of the trials involved. Results ： There were 29 randomized control trials （ 3028 patients ） reviewed. All trials involved were low quality.Of the 23 trials of oral administration of Chinese medicine in comparison with western drugs, 20 ones showed that the therapeutic effect of the experimental group was better than the control group, and 3 ones showed that there was no significant difference between the two groups.Of the 5 trials of external application of Chinese medicine in comparison with western drugs only,4 ones showed that the therapeutic effect of the experimental group was better than the control group, and one trial showed that there was no significant difference between the two groups.The comparison of intervention measures on the whole, the clinical total effective rate of the Chinese medicine were better than those of the western drugs only.There was no obvious adverse effect reported in the trials of oral administration of Chinese medicine treatment.There were red papules on the skin reported in the trials of external application of Chinese medicine treatment. Conclusion ： Chinese medicine is effective in the treatment of persistent diarrhea but methodology needs to be improved urgently.