电针与促胃动力药治疗功能性便秘的系统评价

Systematic review on the treatment of functional constipation with electroacupuncture and gastro-kinetic drugs

目的:比较电针治疗与促胃动力药治疗功能性便秘的疗效与安全性。方法:以"功能性便秘""普芦卡必利""莫沙必利""电针""随机对照试验""functional constipation""prucalopride""mosapridecitrate""electroacupuncture""randomized controlled trial"为检索词,检索中国生物医学文献光盘数据库(CMB)、万方、维普(VIP)、中国知网(CNKI)、Open Grey、CINAHL、Cochrane Library、The Joanna Briggs Institute Library(JBI)、PubMed、Web of Science(WOS)、Ovid数据库中关于电针与促胃动力药对功能性便秘患者疗效比较的随机对照试验,均从建库起至2018年6月。2名研究者参考Cochrane Handbook筛选文献、提取资料与评价文献质量后,采用RevMan 5.3软件进行Meta分析。结果:最终纳入11篇文献,共744例患者。经Meta分析发现,电针组在周自主排便次数、患者便秘相关生活质量、抑郁缓解及不良反应发生率方面优于促胃动力药物组;电针组在粪便性状及排便困难程度改善方面的疗效优于促胃动力药物组或疗效相当。结论:电针治疗功能性便秘的疗效及安全性优于促胃动力药物或与其效果相当,具有良好的治疗前景。

Objective To compare the therapeutic effect and safety in treatment of functional constipation between electroacupuncture(EA)and gastro-kinetic drugs.Methods Using"functional constipation","prucalopride","mosapridecitrate","electro-acupuncture"and"randomized controlled trial",both in Chinese and English,as search terms,the articles of randomized controlled trial(RCT)regarding to the comparison of therapeutic effect on functional constipation in the patients between EA and gastro-kinetic drugs were retrieved from CMB,Wanfang,VIP,CNKI,OpenGrey,CINAHL,Cochrane Library,JBI,PubMed,WOS and Ovid databases.The retrieval time was from the establishment date to June 2018.The two researchers screened articles,extracted data and assessed literature quality in reference to Cochrane Handbook.Using RevMan 5.3 software,the meta-analysis was conducted.Results A total of 11 articles were included finally,with 744 patients involved.It was found after meta-analysis that in EA group,the weekly spontaneous defecation frequency,constipation related quality of life in patients,depression relief and incidence of adverse reaction were all better than those in gastro-kinetic medication group.The therapeutic effect of the improvements in stool character and defecation difficulty in EA group were better or similar to that in gastro-kinetic medication group.Conclusion Regarding the therapeutic effect and safety in treatment of functional constipation,the results of electroacupuncture are superior or similar to gastro-kinetic medication,presenting a satisfactory therapeutic prospect.