不同插管深度的中药保留灌肠对慢性盆腔炎病人疗效影响的Meta分析

Influence of traditional Chinese medicine retention enema with different intubation depth on patients with chronic pelvic inflammatory disease:a Meta-analysis

目的:评价不同插管深度的中药保留灌肠法治疗慢性盆腔炎(CPID)病人的临床疗效。方法:检索PubMed、EMbase、Web of Science、中国知网(CNKI)、维普(VIP)、万方(WanFang Database)、中国生物医学文献数据库(CBM)等中英文数据库中有关不同中药灌肠插管深度对CPID病人临床疗效影响的随机对照试验,检索时限为2011年1月1日—2021年10月24日。由2位研究员独立筛选文献,并进行提取资料、质量评价等,最后采用RevMan 5.4软件进行Meta分析。结果:共纳入12篇文献,包含1 408例病人。Meta分析结果显示,与对照组比较,观察组能提高临床疗效[总有效率:OR=5.76,95%CI(3.81,8.71),P<0.000 01,痊愈率:OR=2.86,95%CI(1.94,4.22),P<0.000 01],增加药物在肠内的保留时间[OR=8.69,95%CI(5.18,14.57),P<0.000 01];在进行灌肠操作时能提高一次性插管成功率,并减少药物外溢、肛门疼痛、管道脱出等不良反应的发生率,差异均有统计学意义(P<0.05)。结论:现有证据表明,延长插管深度至25~30 cm的中药保留灌肠法对CPID病人的临床疗效值得肯定,但纳入研究的方法学质量一般,期待更多高质量研究继续探究最佳插管深度,以期为CPID中药保留灌肠技术标准的制定作部分参考依据。

Objective:To evaluate the clinical efficacy of traditional Chinese medicine retention enema with different intubation depth in the treatment of patients with chronic pelvic inflammation(CPID).Methods:The databases of PubMed,EMbase,Web of Science,CNKI,VIP,WanFang Database and CBM were searched,and randomized controlled trials about the effects of different depth of enema intubation on clinical efficacy of patients with CPID were included,the retrieval time was from January 1,2011 to october 24,2021.Two researchers independently screened the literature and extracted data.Finally RevMan 5.4 software was used for Meta-analysis.Results:A total of 12 papers were incorporated,including 1 408 patients.The results of Meta-analysis showed that compared with the Control group,the observation group could improve the clinical effect[the total effective rate:OR=5.76,95%CI(3.81,8.71),P<0.000 01,the cure rate:OR=2.86,95%CI(1.94,4.22),P<0.000 01],and the retention time in the intestine[OR=8.69,95%CI(5.18,14.57),P<0.000 01].And it could improve the success rate of one-time intubation,and reduce the incidence of adverse reactions such as drug spillover,anal pain,and pipe protruding(P<0.05).Conclusion:The clinical effect of retention enema with prolonging the intubation depth to 25~30 cm on patients with CPID is worth affirming,but the methodological quality of included trials was suboptimal.It needs high-quality research to explore the best intubation depth,in order to provide some reference for the formulation of the technical standard of retention enema for CPID.