承气汤类药物治疗卒中后便秘的Meta分析

Meta一analysis of Chengqi Decoction(承气汤)in Treating Constipation after Stroke

目的系统评价承气汤类药物治疗卒中后便秘的临床疗效和功能恢复状况。方法经过检索中外文数据库,取得所有以承气汤类药物为主治疗卒中后便秘的临床随机对照试验。采Rev Man 5.4软件进行总结归纳和Meta分析。结果共纳入18个随机对照试验研究,1365例受试者。Meta分析结果提示承气汤类药物的疗效优于对照组(OR=6.77,95%CI[4.57,10.03],P<0.000 01);承气汤类药物对便秘症状的改善程度优于对照组(MD:-3.77,95%CI[-4.26,-3.28],P<0.00001);承气汤类药物对神经功能缺损程度的改善优于对照组(MD:-2.79,95%CI[-4.01,-1.57],P<0.000 01);承气汤类药物对中医症候的改善优于对照组(MD:-2.33,95%CI[-4.35,-0.31],P=0.02),差异均具有统计学意义。结论阐明承气汤类药物可以有效治疗卒中后便秘,对照其余治疗方法有一定的优势,但归入文献中RCT文献质量不高,还需高质量、大样本、多中心的临床随机对照试验进一步提高上述证据强度。

Objective To systematically evaluate the clinical efficacy and functional recovery of Chengqi Decoction( 承气汤) drugs in the treatment of post-stroke constipation. Method By searching Chinese and foreign databases,all clinical randomized controlled trials of Chengqi decoction drugs as the main treatment for post-stroke constipation were obtained. Rev Man 5. 4 software was used for collation and Meta-analysis. Results A total of 18 randomized controlled trial studies with 1365 subjects were included. Meta-analysis results suggested that the efficacy of Chengqi Decoction drugs was better than that of the control group( OR = 6. 77,95% CI [4. 57,10. 03 ],P< 0. 000 01);the improvement of constipation symptoms by Chengqi Decoction drugs was better than that of the control group,( MD:-3. 77,95% CI [-4. 26,-3. 28],P< 0. 00001);the improvement of neurological deficits by Chengqi Decoction drugs was better than that of the control group,( MD:-2. 79,95% CI[-4. 01,-1. 57],P< 0. 000 01);and the improvement of TCM symptoms by Chengqi Decoction drugs was better than that of the control group,( MD:-2. 33,95% CI [-4. 35,-0. 31],P = 0. 02),and the differences were statistically significant. Conclusion Chengqi decoction drugs can effectively treat constipation after stroke,and have certain advantages compared with other treatment methods. However,the quality of RCT literatures in the included literatures is low,and high-quality,large-sample,multicenter clinical randomized controlled trials are needed to further improve the strength of the above evidence.