疏肝健脾法治疗腹泻型肠易激综合征随机对照临床研究Meta分析

Clinically Randomized Control Trials of Liver Dispersing with Spleen Strengthening for Irritable Bowel Syndrome Dominated by Diarrhea: A Meta- analysis

目的:系统评价疏肝健脾法治疗腹泻型肠易激综合征的临床疗效,为临床治疗提供参考和帮助。方法:计算机检索Cochrane Library、Pub Med、Embase、中国期刊全文数据库(CNKI)、万方数据库、维普中文科技期刊数据库(VIP)、中国生物医学文献数据库(CBM)关于疏肝健脾法治疗腹泻型肠易激综合征的随机对照试验文献,文献检索时限均从建库至2015年4月,使用Rev Men5.2软件对结果进行Meta分析。结果:共纳入10篇文献,合计781例患者,Meta分析结果显示疏肝健脾法(中药、中成药、针灸)治疗腹泻型肠易激综合征的总有效率优于常规西药对照组[总有效率:OR=3.94,95%CI(2.58-6.01),P<0.01],且能显著改善腹痛、腹胀、大便性状症状,但精神症状未得到显著改善。结论:疏肝健脾法(中药、中成药、针灸)治疗腹泻型肠易激综合征可以有效缓解患者总体症状,尤其是腹痛、腹胀、大便性状,无严重不良反应,安全性尚可。

Objective： The clinically therapeutic effect of liver dispersing with spleen strengthening for irritable bowel syndrome by diarrhea was systematically analyzed to provide reference and asssistance for its clinical treatment and research. Methods： By searching in the Cochrane Library,Pub Med,Embase,CNKI,Wangfang,VIP,CBM,clinically randomized controlled trials（ RCT） of liver dispersing with spleen strengthening for irritable bowel syndrome by diarrhea published from inception to April 2015 were collected while Revman 5. 2 software was applied to perform the Meta- analysis. Results： Ten studies involving 781 participants were included in our Meta- analysis. The results showed that liver dispersing with spleen strengthening（ herbs,Chinese patent drug,acupuncture） had an advantage over western medicine in the treatment of IBS- D[total efficacy ： OR = 3. 94,95% CI（ 2. 58- 6. 01）,P〈0. 01],and the symptoms of abdominal pain,abdominal distention and stool consistency were relieved,but the mental symptom was not significantly relieved. Conclusion： Liver dispersing with spleen strengthening（ herbs,Chinese patent drug,acupuncture） is effective for IBS- D patients in relieving clinical symptoms,especially in the symptoms of abdominal pain,abdominal distention and stool consistency. It is safe and there is no serious adverse reaction.