四磨汤为基础治疗便秘型肠易激综合征的Meta分析

Meta-analysis of Constipation-predominant Irritable Bowel Syndrome Treated by Simo Tang(四磨汤)

目的:对四磨汤为基础治疗便秘型肠易激综合征(IBS)的临床疗效和安全性进行系统评价。方法:计算机检索国内外6个数据库有关四磨汤为基础治疗便秘型IBS的随机对照试验(RCTs),检索时间为各数据库建库至2017年1月1日,由2名评价者根据Cochrane系统评价员手册5.2独立对纳入研究的质量进行评价和提取有效资料,采用Rev Man5.3软件进行Meta分析。结果:最终纳入10个RCT研究,共816例患者,其中治疗组413例,对照组403例。Meta分析显示:四磨汤组与其他药物组的总有效率比较,差异无统计学意义[OR=2.44,95%CI(0.76,7.83),P>0.05]。四磨汤+其他药物组与其他药物组的总有效率比较,差异有统计学意义[OR=4.68,95%CI(2.92,7.52),P<0.01]。2组病例均未发生明显毒副作用。结论:四磨汤单用效果未见明显优势;四磨汤与其他药物联合使用效果优于常规单纯西医组,且未发现明显不良反应。由于所纳入的临床试验的方法学质量较低,因此仍需高质量、多中心、大样本的随机对照试验加以验证。

Objective： To evaluate the clinical efficacy and safety of Simo tang （四磨汤） in treating consti- pation-predominant irritable bowel syndrome （IBS-C）. Method： By retrievalling of electronic databases, we search 6 databases of domestic and abroad, relating to randomized controlled trials about base on Simo tang in treating constipation-predominant irritable bowel syndrome. The retrieval time limit for each database is to January 1, 2017. Two researchers independently assessed the quality of the included studies and extracted valid data on the basis of the Cochrane system assessor handbook 5.1, and made a Meta-analysis by using RevMan 5.3 software. Results： Totally 10 RCTs involving 816 patients were included into the study. Meta analysis results show that The Simo tang group and other groups in the total effective rate had no significant difference, OR=2.44 95%, C1（0.76,7.83）,P〉0.05. Simo tang ＋ other drug group and other groups in the total efficiency comparison was sta- tistically significant, OR=4.68 95%, CI（2.92,7.52）,P〈0.01. Adverse reactions, two groups of cases did not have significant side effects. Conclusion： It with no obvious advantage of Simo tang. Simo tang decoction combined with other drugs use effect is better than the conventional western medicine group, and no obvious side effects. Because of the low methodological quality of the included clinical trials, high quality, multi center, large sample randomized controlled trials are needed.