Objective:To systematically review the efficacy and clinical safety of Qizhi Weitong Granules(气滞胃痛颗粒)(QZWT)in the treatment of irritable bowel syndrome with predominant constipation(IBS-C).Methods:Randomized con...Objective:To systematically review the efficacy and clinical safety of Qizhi Weitong Granules(气滞胃痛颗粒)(QZWT)in the treatment of irritable bowel syndrome with predominant constipation(IBS-C).Methods:Randomized controlled trials(RCTs)of QZWT in patients with IBS-C were retrieved from Pub Med,EMBASE,Cochrane Library,China National Knowledge Infrastructure(CNKI),Wanfang,Chinese Scientific Journals Database(VIP),and Chinese Biological Medical Database(CBM)from inception to December 3,2022.Conventional meta-analysis with random-effects model or fixed-effects model and trial sequential analysis(TSA)were performed by Review Manager 5.4,Stata and TSA software.Results:A total of 4 RCTs and 368 patients with IBS-C were included in this study.The findings of the meta-analysis indicated that the cure and efficacy rate of the experimental group was significantly higher than that of the control group[RR=2.19;(95%CI,1.35–3.55),P<0.01;RR=1.14;(95%CI,1.03–1.27),P<0.05],while the result of Bristol Score was negative.The funnel plot was probably symmetry,and the P value was>0.05 in the Egger test,which confirmed the nonexistence of significant publication bias in this outcome.TSA showed the cumulative z-value crossed the traditional threshold and TSA threshold,while it didn't get to the required information size.Finally,2 studies reported adverse events after QZWT treatment,including 3 cases of diarrhea.No serious adverse events were reported.Conclusion:QZWT was an effective and safe complementary therapy in the treatment of IBS-C with no obvious adverse reactions.TSA analysis confirmed our meta-analysis results.Therefore,QZWT may be a potential candidate for the treatment of IBS-C.However,due to the limited quality of current studies,more long-term,randomized,double-blinded clinical trials are needed in future studies.展开更多
目的:评价推拿疗法治疗儿童和成人功能性消化不良(FD)的疗效和安全性。方法:收集PubMed、荷兰医学文摘(EMBASE)、Cochrane Library、Web of Science、中国生物医学文献数据库(CBM)、万方学术期刊全文数据库(Wanfang)、中国知网(CNKI)和...目的:评价推拿疗法治疗儿童和成人功能性消化不良(FD)的疗效和安全性。方法:收集PubMed、荷兰医学文摘(EMBASE)、Cochrane Library、Web of Science、中国生物医学文献数据库(CBM)、万方学术期刊全文数据库(Wanfang)、中国知网(CNKI)和重庆维普数据库(CQVIP)的相关文章。检索时间截止到2022年3月。两名研究人员独立筛选文献,提取数据,并评估偏倚风险。使用RevMan 5.4软件进行meta分析。结果:共纳入19项临床试验,其中9项为成人研究,10项为儿童研究,共纳入1961例患者。分析结果显示推拿治疗小儿和成人FD的有效率均显著高于对照组[风险比(RR)=1.15,95%可信区间(CI)(1.09,1.21),P<0.001],[RR=1.13,95%CI(1.06,1.21),P<0.001]。此外,推拿联合其他疗法治疗小儿及成人FD的有效率均显著高于对照组[RR=1.14,95%CI(1.07,1.21),P<0.001],[RR=1.12,95%CI(1.02,1.24),P=0.02]。与口服西药比较,推拿可降低成人的上腹部烧灼感评分[标准均数差(SMD)=-0.41;95%CI(-0.79,-0.02);Z=2.08;P=0.04]。相较口服中药(CM)或中成药(CPM)治疗的FD患儿,推拿联合CM或CPM治疗后,FD患儿胃脘痛评分降低[SMD=-0.38,95%CI(-0.56,-0.19);Z=3.96;P<0.001],餐后饱腹感不适[SMD=-0.30,95%CI(-0.50,-0.10);Z=2.88;P=0.004],早期饱腹症状[SMD=-0.26,95%CI(-0.47,-0.06);Z=2.54;P=0.01]。推拿治疗组无不良事件报告,且随访显示推拿组症状评分得到改善。结论:与对照组相比,推拿治疗和推拿联合其他疗法均有更好的有效率、更低的不良事件发生率和更好的随访结局。对于成人,与口服西药治疗相比,推拿疗法可降低上腹部烧灼感评分。对于FD患儿,与单服CPM相比,推拿联合CPM治疗可降低患儿上腹部疼痛、餐后饱胀不适感和早饱症状评分。本研究结果提示推拿可能是一种临床可行的补充疗法。但是由于所纳研究的数量和质量的限制,上述结论需要更多高质量研究的补充验证。展开更多
基金supported by National Natural Science Foundation of China:International (regional)cooperation and exchange project (81820108033)China Academy of Chinese Medical Sciences Youth Talent Project (ZZ14-YQ-020)。
文摘Objective:To systematically review the efficacy and clinical safety of Qizhi Weitong Granules(气滞胃痛颗粒)(QZWT)in the treatment of irritable bowel syndrome with predominant constipation(IBS-C).Methods:Randomized controlled trials(RCTs)of QZWT in patients with IBS-C were retrieved from Pub Med,EMBASE,Cochrane Library,China National Knowledge Infrastructure(CNKI),Wanfang,Chinese Scientific Journals Database(VIP),and Chinese Biological Medical Database(CBM)from inception to December 3,2022.Conventional meta-analysis with random-effects model or fixed-effects model and trial sequential analysis(TSA)were performed by Review Manager 5.4,Stata and TSA software.Results:A total of 4 RCTs and 368 patients with IBS-C were included in this study.The findings of the meta-analysis indicated that the cure and efficacy rate of the experimental group was significantly higher than that of the control group[RR=2.19;(95%CI,1.35–3.55),P<0.01;RR=1.14;(95%CI,1.03–1.27),P<0.05],while the result of Bristol Score was negative.The funnel plot was probably symmetry,and the P value was>0.05 in the Egger test,which confirmed the nonexistence of significant publication bias in this outcome.TSA showed the cumulative z-value crossed the traditional threshold and TSA threshold,while it didn't get to the required information size.Finally,2 studies reported adverse events after QZWT treatment,including 3 cases of diarrhea.No serious adverse events were reported.Conclusion:QZWT was an effective and safe complementary therapy in the treatment of IBS-C with no obvious adverse reactions.TSA analysis confirmed our meta-analysis results.Therefore,QZWT may be a potential candidate for the treatment of IBS-C.However,due to the limited quality of current studies,more long-term,randomized,double-blinded clinical trials are needed in future studies.
基金国家自然科学基金国际(地区)合作与交流项目,No.81820108033The registration number of this study in International Prospective Register of Systematic Reviews is CRD42022321222.
文摘目的:评价推拿疗法治疗儿童和成人功能性消化不良(FD)的疗效和安全性。方法:收集PubMed、荷兰医学文摘(EMBASE)、Cochrane Library、Web of Science、中国生物医学文献数据库(CBM)、万方学术期刊全文数据库(Wanfang)、中国知网(CNKI)和重庆维普数据库(CQVIP)的相关文章。检索时间截止到2022年3月。两名研究人员独立筛选文献,提取数据,并评估偏倚风险。使用RevMan 5.4软件进行meta分析。结果:共纳入19项临床试验,其中9项为成人研究,10项为儿童研究,共纳入1961例患者。分析结果显示推拿治疗小儿和成人FD的有效率均显著高于对照组[风险比(RR)=1.15,95%可信区间(CI)(1.09,1.21),P<0.001],[RR=1.13,95%CI(1.06,1.21),P<0.001]。此外,推拿联合其他疗法治疗小儿及成人FD的有效率均显著高于对照组[RR=1.14,95%CI(1.07,1.21),P<0.001],[RR=1.12,95%CI(1.02,1.24),P=0.02]。与口服西药比较,推拿可降低成人的上腹部烧灼感评分[标准均数差(SMD)=-0.41;95%CI(-0.79,-0.02);Z=2.08;P=0.04]。相较口服中药(CM)或中成药(CPM)治疗的FD患儿,推拿联合CM或CPM治疗后,FD患儿胃脘痛评分降低[SMD=-0.38,95%CI(-0.56,-0.19);Z=3.96;P<0.001],餐后饱腹感不适[SMD=-0.30,95%CI(-0.50,-0.10);Z=2.88;P=0.004],早期饱腹症状[SMD=-0.26,95%CI(-0.47,-0.06);Z=2.54;P=0.01]。推拿治疗组无不良事件报告,且随访显示推拿组症状评分得到改善。结论:与对照组相比,推拿治疗和推拿联合其他疗法均有更好的有效率、更低的不良事件发生率和更好的随访结局。对于成人,与口服西药治疗相比,推拿疗法可降低上腹部烧灼感评分。对于FD患儿,与单服CPM相比,推拿联合CPM治疗可降低患儿上腹部疼痛、餐后饱胀不适感和早饱症状评分。本研究结果提示推拿可能是一种临床可行的补充疗法。但是由于所纳研究的数量和质量的限制,上述结论需要更多高质量研究的补充验证。
