利那洛肽对便秘型肠易激综合征有效并改善患者生活质量的Meta分析

Linaclotide improves quality of life in patients with irritable bowel syndrome with constipation:A Meta-analysis

目的:评价利那洛肽与安慰剂对比在便秘型肠易激综合征(irritable bowel syndrome with constipation,IBS-C)患者中的疗效及安全性.方法:中国期刊全文数据库(China National Knowledge Internet,CNKI),中国生物医学文献数据库(China Biology Medicine,CBM)、中国万方数据库、中国维普数据库、PubMed、Embase、Web of science、Cochrane library和clinical trials.gov等数据库中关于利那洛肤应用于成人IBS-C的与安慰剂对照的随机对照试验.结果用RevMan v5.2版本统计了相对危险因素(relative risk,RR)和95%可信区间(confidence intervals,CI)等二分类资料.结果:检索出符合要求的关于利那洛肽用于IBS-C的3个随机对照试验的4篇公开发表的文章,主要观察指标为:腹痛的效果(RR=1.58,95%CI:1.02-2.46);对完全性自发排便(complete spontaneous bowel movements,CSBMs)的改善(RR=3.19,95%CI:2.40-4.25);患者生活质量的改善(RR=1.38,95%CI:1.09-1.74).利那洛肽还在改善大便性状、减少腹痛、腹胀和所有严重症状方面发挥作用.与安慰剂相比,腹泻是利那洛肤最常发生的不良反应.结论:通过本研究比较得知,利那洛肽与安慰剂相比,能改善肠道功能,减轻腹痛症状和改善IBS-C患者的生活质量.

AIM： To perform a meta-analysis to determine the efficacy and the safety of linaclotide, compared with placebo, for patients with irritable bowel syndrome with constipation （IBS-C）. METHODS： CNKI, CBM, W EMBASE, clinical trials.gov and the Cochrane library were searched for randomized, placebo controlled trials examining the effect of linaclotide in adults with IBS-C. Dichotomous results were pooled by using the RevMan v.5.2 software to yield relative risks （RRs） and 95% confidence intervals （CIs） RESULTS： The search identified three randomized controlled trials of linaclotide in patients with IBS-C published in four papers. Meta-analysis suggested that linaclotide significantly improved abdominal pain （RR = 1.58, 95%CI： 1.02-2.46）, complete spontaneous bowel movements （CSBMs） （RR = 3.19, 95%CI： 2.40-4.25） and quality of life （RR = 1.38, 95%Ch 1.09-1.74）. Linaclotide also improved stool form and reduced the severity of abdominal pain, bloating and overall symptoms in patients with IBS-C. Diarrhoea was the most frequent adverse event （AE） in the group of linaclotide. CONCLUSION： Our study suggests that linaclotide significantly improves bowel function, reduces abdominal pain and improves quality of life in patients with IBS-C.