针灸与药物治疗单纯性功能性便秘疗效的系统评价

Systematic Evaluation of Acupuncture and Drug Control for the Treatment of Simple Functional Constipation

评价针灸与药物对照治疗单纯性功能性便秘的优效性。按照循证医学的要求全面检索关于针灸治疗单纯性功能性便秘的国内外文献,选择符合要求的随机对照试验(RCT)和临床对照试验(CCT)进行系统评价,并使用专门的统计学软件对其进行Meta分析。结果显示针灸无论是近期有效率、愈显率(包括治疗前后的自主排便次数、CCS、症状量表评分比较方面),还是远期有效率,均不亚于药物组,且随访复发率低,安全性均良好。另腹部天枢深刺电针组在CCS评分方面优于药物组,但在改善自主排便方面与药物组疗效相当。而天枢常规刺电针与药物组在CCS评分方面效果无明显差别。但因所纳文献少,敏感性分析较大,存在发表偏倚,且大多量表指标未给予差值分析,导致Meta分析有一定的困难,故尚需较大样本的多中心对照试验和进一步的临床规范化指标予以证实。

Evaluate the effect of acupuncture and drug control for the treatment for simple functional constipa- tion. According to the requirements of Evidence - based medicine, we research domestic and foreign literature overall about acupuncture treatment for simple functional constipation, and choose the qualified randomized con- trolled trial （RCT） and controlled clinical trials （CCT） for the systematic evaluation, and use special statistical software for Meta- analysis. The results show that acupuncture is not inferior to the drug control group both in the recent effective rate ,the markedly effective rate, including improving the symptoms of independent stool fre- quency, CCS and symptoms scale, and in the forward efficient, what is more, it is safe and the follow - up re- currence rate is low. The deep acupuncture method at Tianshu （ ST 25 ） in improving the CCS is superior to the drug control group, but has the equivalent efficacy in the independent defecation. And the effect of routine acu- puncture method at Tianshu （ST 25 ） in improving the CCS is similar compared with drug control group. But due to the less literature, sensitivity analysis, publication bias exists, and there is no difference analysis on most rating scales. Meta analysis has some difficulty, and it remains to be a larger sample of multicenter con- trolled trial and further standardization of clinical indicators.