大承气汤加减治疗胸腰椎骨折后便秘的疗效Meta分析

Meta Analysis of the Effect of the Constipation after Thoracolumbar Fracture with Dachengqi Decoction

目的:系统评价大承气汤加减治疗胸腰椎骨折后便秘的临床疗效。方法:计算机检索中外数据库中大承气汤加减治疗胸腰椎骨折后便秘的随机对照试验,经文献筛选、资料提取及质量评价后,采用Review Manager 5.2软件进行Meta分析。结果:最终17篇文献纳入研究,共计1 614例患者,其中治疗组849例,予以大承气汤加减或中西医结合治疗;对照组765例,予以西医治疗。纳入文献的异质性检验(χ2=16.20,P=0.44>0.10;I2=1%<50%),表明纳入文献同质性好,可采用固定效应模型分析;合并后的效应量OR=7.32,95%CI^([5.21,10.28]),Z=11.50(P<0.00001),表明治疗组总有效率高于对照组;根据漏斗图中散点分布不对称,表明存在发表偏倚的可能性较大。结论:大承气汤加减对胸腰椎骨折后便秘治疗效果显著,但仍需更多高质量研究进一步论证结论,且需要对其安全性进行评价。

Objective：To evaluate the clinical efficacy of Dachengqi decoction in the treatment of constipation after thoracolumbar fracture. Methods ： A randomized controlled trial of Dachengqi decoction in the treatment of constipation after thoracolumbar frac- ture in Chinese and foreign databases. After reviewing the literature, data extraction and quality evaluation, Meta analysis was per- formed using Review Manager 5.2 software. Results：Finally, 17 articles were included, totaling 1614 cases, including 849 cases in the treatment group and 765 cases in the control group. The treatment group was treated with Dachengqi decoction or integrative medicine therapy. The control group was given western medicine treatment. The heterogeneity of the literature（x2 =16.20, P= 0.44 〉0. 10;I2 = 1 %〈50% ））,indicating that the incorporation of literature is homogeneous and can be analyzed by fixed effect model; The effect of the combined effect（ OR =7.32,95% CI [5.21.10.28], Z =11.50（P〈0. 00001） ,indicating that the total effective rate of the treatment group was higher than the control group. The funnel diagram drawn by the software shows asymmetric distribution, in- dicating that there is a greater likelihood of publication bias. Conclusion. The treatment of constipation after thoracolumbar fracture is significantly affected by Dachengqi decoction,But more high quality research is needed to further demonstrate the conclusions,and its securityneed to be evaluated.