中药贴敷在胸腰椎术后腹胀及便秘应用研究的Meta分析

Meta Analysis of Application of Chinese Herbal Paste in Abdominal Distension and Constipation After Thoracolumbar Surgery

目的 系统评价中药贴敷治疗对胸腰椎术后腹胀及便秘的临床疗效。方法 通过检索Cochrane图书馆、PubMed、Ovid、Web of Science、中国生物医学文献数据库、中国知网、维普资讯网、万方数据库中从建库至2021年发表的关于中药贴敷治疗对胸腰椎术后腹胀及便秘的随机对照试验,纳入研究按照Cochrane系统评价方法进行质量评价和提取资料,采用RevMan 5.4软件进行Meta分析。结果 共纳入文献17篇,共计患者1399例,其中观察组699例,对照组700例。描述性分析结果显示,所有纳入研究中观察组的首次排便时间、首次排气时间均较对照组提前;Meta分析结果显示,观察组肠鸣音恢复时间(MD=-8.16,95%CI:-9.96~-6.37,P<0.000 01)早于对照组,术后腹胀便秘发生率(OR=0.27,95%CI:0.16~0.46,P<0.000 01)低于对照组,总有效率(OR=6.4,95%CI:4.14~9.88,P<0.000 01)高于对照组,差异均有统计学意义(P<0.05)。结论 应用中药贴敷治疗胸腰椎术后腹胀及便秘,能够促进患者排便排气,肠鸣音恢复,降低术后腹胀便秘发生率,提高临床治疗总有效率。

Objective To systematically evaluate the clinical efficacy of traditional Chinese medicine application on abdominal distension and constipation after thoracolumbar surgery.Methods By searching the Cochrane Library, PubMed, Ovid, Web of Science, China Biomedical Literature Database, China National Knowledge Infrastructure, VIP Information Network, Wanfang Database from the establishment of the database to 2021, the randomized controlled trials on the treatment of abdominal distension and constipation after thoracolumbar spine surgery were published. The quality evaluation and data extraction were carried out according to the Cochrane system evaluation method. Meta-analysis was performed using RevMan 5.4software.Results A total of 17 literatures were included, with a total of 1399 patients, including 699 patients in the observation group and 700patients in the control group. The results of descriptive analysis showed that the first defecation time and the first exhaust time of the observation group were earlier than those in the control group. The results of Meta-analysis showed that the recovery time of bowel sounds in the observation group(MD=-8.16, 95%CI:-9.96--6.37, P<0.000 01) was earlier than that in the control group, the incidence of postoperative abdominal distension and constipation(OR=0.27, 95%CI:0.16-0.46, P<0.000 01) was lower than that in the control group, and the total effective rate(OR=6.4, 95%CI:4.14-9.88, P<0.000 01) was higher than that in the control group, the differences were statistically significant( P<0.05).Conclusion The application of traditional Chinese medicine application in the treatment of abdominal distension and constipation after thoracolumbar surgery can promote defecation and exhaust, recovery of bowel sounds, reduce the incidence of postoperative abdominal distension and constipation, and improve the total effective rate of clinical treatment.