白术七物颗粒联合针灸治疗慢传输型便秘临床疗效Meta分析

Meta-analysis of clinical efficacy of Baizhu Qiwu Granules combined with acupuncture in treatment of slow transit constipation

目的:系统评价白术七物颗粒联合针灸治疗慢传输型便秘的临床疗效。方法:检索建库至2023年7月时间范围内中国生物医学数据库(CBM)、中国知网(CNKI)、PubMed、万方(WanFang)、Embase、维普中文科技期刊数据库(CCD)、The Cochrane Library国内外数据库,筛选纳入临床随机对照试验(RCT)类型研究文献,运用Revman 5.0软件进行数据分析及系统评价、Stata 17.0软件评价发表偏倚、TSA 0.9.5软件进行试验序贯分析、Gradepro 3.6软件评估结局指标。结果:纳入4篇文献,总共287例患者,其中干预组239例,对照组149例。Meta亚组分析结果显示,白术七物颗粒联合针灸治疗慢传输型便秘在临床总有效率、治愈率及X线标志物残留数上均明显优于对照组,差异有统计学意义(RR=1.38,95%CI:1.26~1.52,P<0.01;RR=2.52,95%CI:1.59~3.99,P<0.01;SMD=-2.22,95%CI:-3.23~-1.22,P<0.01)。Stata 17.0软件敏感性分析结果显示不存在显著发表偏倚。TSA 0.9.5软件结果表明结论具备可靠性。结论:白术七物颗粒联合针灸治疗慢传输型便秘临床疗效显著,但受到纳入文献质量及样本量限制,仍需进一步扩大样本量进行多中心、多指标、多样本的临床随机对照试验进行验证。

Objective:To systematically evaluate the clinical efficacy of Baizhu Qiwu Granules combined with acupuncture on slow transit constipation.Methods:Chinese Biology Medicine(CBM),China National Knowledge Infrastructure(CNKI),PubMed,WanFang,Embase,China Science and Technology Journal Database(CCD)and The Cochrane Library were searched from the establishment of the database to July 2023.Clinical randomized controlled trial(RCT)type research articles were screened and included.Revman 5.0 software was used for data analysis and system assessment,the publication bias was evaluated by Stata 17.0 software,the sequential analysis of trials were performed by TSA 0.9.5 software,and the outcome indicators were evaluated by Gradepro 3.6 software.Results:A total of 287 patients were included in 4 articles,including 239 in the intervention group and 149 in the control group.The results of meta-subgroup analysis showed that the total clinical effective rate,cure rate and residual number of X-ray markers in the treatment of slow transit constipation with Bazhu Qiwu Granules combined with acupuncture were significantly better than those in the control group,and the differences were statistically significant(RR=1.38,95%CI:1.26~1.52,P<0.01;RR=2.52,95%CI:1.59~3.99,P<0.01;SMD=-2.22,95%CI:-3.23~-1.22,P<0.01).Sensitivity analysis of Stata 17.0 software showed that there was no significant publication bias.The results of TSA 0.9.5 software showed that the conclusion was reliable.Conclusion:Baizhu Qiwu Granules combined with acupuncture has a significant clinical effect on slow transit constipation.However,due to the limitation of the quality and sample size of the included literature,it is still necessary to further expand the sample size and conduct multi-center,multi-index and multi-sample clinical randomized controlled trials to verify.