Objective:To observe the clinical efficacy of Tuina(Chinese therapeutic massage),basically Yi Zhi Chan pushing at Baliao points in the treatment of functional constipation in infants and children aged 1-3 years old.Me...Objective:To observe the clinical efficacy of Tuina(Chinese therapeutic massage),basically Yi Zhi Chan pushing at Baliao points in the treatment of functional constipation in infants and children aged 1-3 years old.Methods:Seventy kids were randomly divided into an observation group and a control group,with 35 cases in each group.The control group was treated with conventional Tuina manipulation,while the observation group was treated with Tuina manipulation based on Yi Zhi Chan pushing at Baliao points.Both groups were treated once every other day,with 10 times as 1 course of treatment.The score on the self-developed constipation rating scale and clinical efficacy were compared after 1 course of treatment.Results:The total effective rate was 90.6%in the observation group and 76.7%in the control group,and the difference between the two groups was statistically significant(P<0.05).The degree of defecation difficulty in the children in the observation group was milder than that in the control group(P<0.01).Conclusion:Tuina manipulation based on Yi Zhi Chan pushing at Baliao points can significantly improve the degree of defecation difficulty in children,and the total effective rate is better than that of conventional Tuina manipulation.展开更多
The second part of the Consensus Statement of the Italian Association of Hospital Gastroenterologists and Italian Society of Colo-Rectal Surgery reports on the treatment of chronic constipation and obstructed defecati...The second part of the Consensus Statement of the Italian Association of Hospital Gastroenterologists and Italian Society of Colo-Rectal Surgery reports on the treatment of chronic constipation and obstructed defecation. There is no evidence that increasing fluid intake and physical activity can relieve the symptoms of chronic constipation. Patients with normal-transit constipation should increase their fibre intake through their diet or with commercial fibre. Osmotic laxatives may be effective in patients who do not respond to fibre supplements. Stimulant laxatives should be re- served for patients who do not respond to osmotic laxatives. Controlled trials have shown that serotonin- ergic enterokinetic agents, such as prucalopride, and prosecretory agents, such as lubiprostone, are effec- tive in the treatment of patients with chronic constipa- tion. Surgery is sometimes necessary. Total colectomy with ileorectostomy may be considered in patients with slow-transit constipation and inertia coil who are resistant to medical therapy and who do not have defecatory disorders, generalised motility disorders or psychological disorders. Randomised controlled trials have established the efficacy of rehabilitative treat- ment in dys-synergic defecation. Many surgical proce- dures may be used to treat obstructed defecation in patients with acquired anatomical defects, but none is considered to be the gold standard. Surgery should be reserved for selected patients with an impaired quality of life. Obstructed defecation is often associated with pelvic organ prolapse. Surgery with the placement of prostheses is replacing fascial surgery in the treatment of pelvic organ prolapse, but the efficacy and safety of such procedures have not yet been established.展开更多
AIM:To investigate the effect of dietary fiber intake on constipation by a meta-analysis of randomized controlled trials(RCTs).METHODS:We searched Ovid MEDLINE(from 1946 to October 2011),Cochrane Library(2011),PubMed ...AIM:To investigate the effect of dietary fiber intake on constipation by a meta-analysis of randomized controlled trials(RCTs).METHODS:We searched Ovid MEDLINE(from 1946 to October 2011),Cochrane Library(2011),PubMed for articles on dietary fiber intake and constipation using the terms:constipation,fiber,cellulose,plant extracts,cereals,bran,psyllium,or plantago.References of important articles were searched manually for relevant studies.Articles were eligible for the meta-analysis if they were high-quality RCTs and reported data on stool frequency,stool consistency,treatment success,laxative use and gastrointestinal symptoms.The data were extracted independently by two researchers(Yang J and Wang HP) according to the described selection criteria.Review manager version 5 software was used for analysis and test.Weighted mean difference with 95%CI was used for quantitative data,odds ratio(OR)with 95%CI was used for dichotomous data.Both I2 statistic with a cut-off of ≥ 50% and the χ2 test with a P value < 0.10 were used to define a significant degree of heterogeneity.RESULTS:We searched 1322 potential relevant articles,19 of which were retrieved for further assessment,14 studies were excluded for various reasons,five studies were included in the analysis.Dietary fiber showed significant advantage over placebo in stool frequency(OR = 1.19;95%CI:0.58-1.80,P < 0.05).There was no significant difference in stool consistency,treatment success,laxative use and painful defecation between the two groups.Stool frequency were reported by five RCTs,all results showed either a trend or a significant difference in favor of the treatment group,number of stools per week increased in treatment group than in placebo group(OR = 1.19;95%CI:0.58-1.80,P < 0.05),with no significant heterogeneity among studies(I2= 0,P = 0.77).Four studies evaluated stool consistency,one of them presented outcome in terms of percentage of hard stool,which was different from others,so we included the other three studies for analysis.Two studies reported treatment success.There was significant heterogeneity between the studies(P < 0.1,I2 > 50%).Three studies reported laxative use,quantitative data was shown in one study,and the pooled analysis of the other two studies showed no significant difference between treatment and placebo groups in laxative use(OR = 1.07;95%CI 0.51-2.25),and no heterogeneity was found(P = 0.84,I2= 0).Three studies evaluated painful defecation:one study presented both quantitative and dichotomous data,the other two studies reported quantitative and dichotomous data separately.We used dichotomous data for analysis.CONCLUSION:Dietary fiber intake can obviously increase stool frequency in patients with constipation.It does not obviously improve stool consistency,treatment success,laxative use and painful defecation.展开更多
Objective: To systematically analyze the therapeutic efficacy and safety of acupuncture in treating functional constipation (FC). Methods: By searching the Cochrane Library, PubMed, Web of Science, Embase, CBM, C...Objective: To systematically analyze the therapeutic efficacy and safety of acupuncture in treating functional constipation (FC). Methods: By searching the Cochrane Library, PubMed, Web of Science, Embase, CBM, CNKI, WanFang databases, the randomized controlled trials (RCTs) comparing acupuncture with Western medication in treating FC were retrieved, from the inception of the databases to September 2013. When the literatures were arranged according to the inclusion and exclusion criteria, and the methodological qualities were evaluated, RevMan 5.2 was adopted for meta-analysis. Results: Ten RCTs were included, covering 1 041 cases of FC. The meta-analysis showed that there was no significant difference in comparing spontaneous bowel movements per week between shallow acupuncture at Tianshu (ST 25) and Western medication [MD=0.47, 95% CI (-1.28, 0.34)]; there was a significant difference in comparing the spontaneous bowel movements per week between deep acupuncture at Tianshu (ST 25) and Western medication [MD =0.53, 95% CI (0.13, 0.92)], but the difference was insignificant according to the sensitivity analysis [MD=0.38, 95% Cl (-0.03, 0.80)], indicating the low reliability of the conclusion. Regarding the Cleveland clinic score (CCS), the difference between shallow acupuncture at Tianshu (ST 25) and Western medication was insignificant [MD = 0.39, 95% Cl (-1.13, 1.91)]; the difference between deep acupuncture at Tianshu (ST 25) and Western medication was significant [MD=2.64, 95% Cl (1.32, 3.97)]. In the evaluation of security, the incidence rate of adverse events in acupuncture treatment (0.31%) was significantly lower than that in Western medication treatment (3.4%). Conclusion: Although the present systematic review showed that deep acupuncture at Tianshu (ST 25) should have better therapeutic efficacy than Western medication, the reliability and quality of the evidences were poor, and thus the above results require proving by more RCTs of higher quality.展开更多
Objective To systematically evaluate the efficacy of heat-sensitive moxibustion in treatment of cervical spondylotic radiculopathy(CSR). Methods Chinese National Knowledge Infrastructure(CNKI), China Biology Medi...Objective To systematically evaluate the efficacy of heat-sensitive moxibustion in treatment of cervical spondylotic radiculopathy(CSR). Methods Chinese National Knowledge Infrastructure(CNKI), China Biology Medical(CBM) database, Chinese Science and Technology Periodical Database(VIP), Wan Fang Data, Pubmed and Cochrane Library were retrieved to search the randomized controlled trials(RCT) on heat-sensitive moxibustion in treatment of CSR, and Meta analysis was conducted by applying Rev Man 5.3 software. Results Eventually, 10 papers were included in this study, including 1008 subjects. Meta analysis result showed: the total effective rate of treatment group was higher than that of control group, and the difference was statistically significant [RR=1.13, 95%CI(1.06, 1.21), Z=3.54, P=0.000 4]; the cure rate of treatment group was higher than that of control group, and the difference was statistically significant [RR=1.80, 95%CI(1.52, 2.13), Z=6.82, P〈0.000 01]; the improvement of short-form Mc Gill pain questionnaire(SF-MPQ) of treatment group was superior to that of control group, and the difference was statistically significant [MD=–4.44, 95%CI(–6.38,-2.50), Z=4.49, P〈0.000 01]; visual analogue scale(VAS) of treatment group was lower than that of control group, and the difference was statistically significant [MD=-0.36, 95%CI(-0.50, –0.23), Z=5.42, P〈0.00001]; and the improvement of interleukin-6(IL-6) of treatment group was superior to that of control group, and the difference was statistically significant [MD=–7.32, 95%CI(-11.49, –3.14), Z=3.44, P=0.000 6]. Conclusion It is indicated from the Meta analysis result that the clinical efficacy of heat-sensitive moxibustion or acupuncture combined with heat-sensitive moxibustion in treatment of CSR is superior to that of simple acupuncture or traditional suspended moxibustion, providing a new therapeutic method for treatment of CSR. However, the abovementioned conclusion still needs to be confirmed through randomized blind controlled trials with high quality and large sample size since the sample size of included studies was small, and the quality was low.展开更多
OBJECTIVE:To assess the efficacy of Traditional Chinese Medicine(TCM)on constipation-predominant irritable bowel syndrome by focusing on the liver.METHODS:Databases(domestic and foreign)were searched with the key word...OBJECTIVE:To assess the efficacy of Traditional Chinese Medicine(TCM)on constipation-predominant irritable bowel syndrome by focusing on the liver.METHODS:Databases(domestic and foreign)were searched with the key words"irritable bowel syndrome","constipation",and"Chinese medicine";the relevant articles were retrieved and evaluated.Cure rate,"remarkable efficacy",recurrence rate and the incidence of adverse reactions were the outcome indicators.Review Manager ver 5.1 was used for this meta-analysis,and funnel plots used to detect publication bias.RESULTS:Nineteen randomized controlled trials were included and 1510 patients involved.The treatment guided byTCM based on the liver was superior to Western Medicine[odds ratio(OR)=2.46,95%confidence interval(CI)1.80,3.35)],cure rate[OR=2.61,95%CI(1.93,3.52)],remarkable efficacy[OR=2.68,95%CI(1.82,3.95)],recurrence rate[OR=0.19,95%CI(0.12,0.29)]and the incidence of adverse reactions[OR=0.24,95%CI(0.09,0.65)].However,funnel plots showed publication bias.CONCLUSION:Compared with Western Medicine,the treatment of IBS-C based on the liver is significantly better but the results must be treated with caution because publication bias was recorded.展开更多
Objective:To observe the clinical effect of heat-sensitive moxibustion plus lactulose oral liquid for postoperative constipation of mixed hemorrhoid.Methods:A total of 70 patients were randomized into a treatment grou...Objective:To observe the clinical effect of heat-sensitive moxibustion plus lactulose oral liquid for postoperative constipation of mixed hemorrhoid.Methods:A total of 70 patients were randomized into a treatment group and a control group,with 35 cases in each group by a random number table.Patients in the control group received lactulose oral liquid alone,while those in the treatment group received additional heat-sensitive moxibustion at Shenque(CV 8).The treatment was given once a day for 15 consecutive days.The defecation interval time,defecation duration,the scores of stool form,visual analog scale(VAS)and patient assessment of constipation quality of life questionnaire(PAC-QOL),as well as the serum substance P(SP)and nitric oxide(NO)levels were measured before and after treatment.Results:After treatment,the stool form score,defecation interval time and defecation duration in the two groups dropped significantly(all P<0.05),and they were lower in the treatment group than in the control group(all P<0.05).After treatment,the VAS scores in the two groups dropped significantly(both P<0.05),and it was lower in the treatment group than in the control group(P<0.05).After treatment,the PAC-QOL scores in the two groups dropped significantly(both P<0.05),and it was lower in the treatment group than in the control group(P<0.05).After treatment,the serum SP and NO levels in the two groups improved significantly(all P<0.05),and showed statistically significant differences between the treatment group and the control group(both P<0.05).Conclusion:Heat-sensitive moxibustion plus lactulose oral liquid can improve stool form,shorten defecation interval time and defecation duration,alleviate defecation pain,and improve quality of life(QOL)for patients with postoperative constipation of mixed hemorrhoid,which may be related to the regulation of the SP and NO levels.展开更多
文摘Objective:To observe the clinical efficacy of Tuina(Chinese therapeutic massage),basically Yi Zhi Chan pushing at Baliao points in the treatment of functional constipation in infants and children aged 1-3 years old.Methods:Seventy kids were randomly divided into an observation group and a control group,with 35 cases in each group.The control group was treated with conventional Tuina manipulation,while the observation group was treated with Tuina manipulation based on Yi Zhi Chan pushing at Baliao points.Both groups were treated once every other day,with 10 times as 1 course of treatment.The score on the self-developed constipation rating scale and clinical efficacy were compared after 1 course of treatment.Results:The total effective rate was 90.6%in the observation group and 76.7%in the control group,and the difference between the two groups was statistically significant(P<0.05).The degree of defecation difficulty in the children in the observation group was milder than that in the control group(P<0.01).Conclusion:Tuina manipulation based on Yi Zhi Chan pushing at Baliao points can significantly improve the degree of defecation difficulty in children,and the total effective rate is better than that of conventional Tuina manipulation.
基金Supported by Associazione Italiana Gastroenterologi and Endoscopisti Digestivi Ospedalieri, Via N Colajanni, 4, 00191 Roma, ItalySocietà Italiana di Chirurgia Colo-Rettale, Via Medici, 23, 10143 Torino, Italy
文摘The second part of the Consensus Statement of the Italian Association of Hospital Gastroenterologists and Italian Society of Colo-Rectal Surgery reports on the treatment of chronic constipation and obstructed defecation. There is no evidence that increasing fluid intake and physical activity can relieve the symptoms of chronic constipation. Patients with normal-transit constipation should increase their fibre intake through their diet or with commercial fibre. Osmotic laxatives may be effective in patients who do not respond to fibre supplements. Stimulant laxatives should be re- served for patients who do not respond to osmotic laxatives. Controlled trials have shown that serotonin- ergic enterokinetic agents, such as prucalopride, and prosecretory agents, such as lubiprostone, are effec- tive in the treatment of patients with chronic constipa- tion. Surgery is sometimes necessary. Total colectomy with ileorectostomy may be considered in patients with slow-transit constipation and inertia coil who are resistant to medical therapy and who do not have defecatory disorders, generalised motility disorders or psychological disorders. Randomised controlled trials have established the efficacy of rehabilitative treat- ment in dys-synergic defecation. Many surgical proce- dures may be used to treat obstructed defecation in patients with acquired anatomical defects, but none is considered to be the gold standard. Surgery should be reserved for selected patients with an impaired quality of life. Obstructed defecation is often associated with pelvic organ prolapse. Surgery with the placement of prostheses is replacing fascial surgery in the treatment of pelvic organ prolapse, but the efficacy and safety of such procedures have not yet been established.
文摘AIM:To investigate the effect of dietary fiber intake on constipation by a meta-analysis of randomized controlled trials(RCTs).METHODS:We searched Ovid MEDLINE(from 1946 to October 2011),Cochrane Library(2011),PubMed for articles on dietary fiber intake and constipation using the terms:constipation,fiber,cellulose,plant extracts,cereals,bran,psyllium,or plantago.References of important articles were searched manually for relevant studies.Articles were eligible for the meta-analysis if they were high-quality RCTs and reported data on stool frequency,stool consistency,treatment success,laxative use and gastrointestinal symptoms.The data were extracted independently by two researchers(Yang J and Wang HP) according to the described selection criteria.Review manager version 5 software was used for analysis and test.Weighted mean difference with 95%CI was used for quantitative data,odds ratio(OR)with 95%CI was used for dichotomous data.Both I2 statistic with a cut-off of ≥ 50% and the χ2 test with a P value < 0.10 were used to define a significant degree of heterogeneity.RESULTS:We searched 1322 potential relevant articles,19 of which were retrieved for further assessment,14 studies were excluded for various reasons,five studies were included in the analysis.Dietary fiber showed significant advantage over placebo in stool frequency(OR = 1.19;95%CI:0.58-1.80,P < 0.05).There was no significant difference in stool consistency,treatment success,laxative use and painful defecation between the two groups.Stool frequency were reported by five RCTs,all results showed either a trend or a significant difference in favor of the treatment group,number of stools per week increased in treatment group than in placebo group(OR = 1.19;95%CI:0.58-1.80,P < 0.05),with no significant heterogeneity among studies(I2= 0,P = 0.77).Four studies evaluated stool consistency,one of them presented outcome in terms of percentage of hard stool,which was different from others,so we included the other three studies for analysis.Two studies reported treatment success.There was significant heterogeneity between the studies(P < 0.1,I2 > 50%).Three studies reported laxative use,quantitative data was shown in one study,and the pooled analysis of the other two studies showed no significant difference between treatment and placebo groups in laxative use(OR = 1.07;95%CI 0.51-2.25),and no heterogeneity was found(P = 0.84,I2= 0).Three studies evaluated painful defecation:one study presented both quantitative and dichotomous data,the other two studies reported quantitative and dichotomous data separately.We used dichotomous data for analysis.CONCLUSION:Dietary fiber intake can obviously increase stool frequency in patients with constipation.It does not obviously improve stool consistency,treatment success,laxative use and painful defecation.
基金supported by National Natural Science Foundation of China(No.30973794 and No.81273839)
文摘Objective: To systematically analyze the therapeutic efficacy and safety of acupuncture in treating functional constipation (FC). Methods: By searching the Cochrane Library, PubMed, Web of Science, Embase, CBM, CNKI, WanFang databases, the randomized controlled trials (RCTs) comparing acupuncture with Western medication in treating FC were retrieved, from the inception of the databases to September 2013. When the literatures were arranged according to the inclusion and exclusion criteria, and the methodological qualities were evaluated, RevMan 5.2 was adopted for meta-analysis. Results: Ten RCTs were included, covering 1 041 cases of FC. The meta-analysis showed that there was no significant difference in comparing spontaneous bowel movements per week between shallow acupuncture at Tianshu (ST 25) and Western medication [MD=0.47, 95% CI (-1.28, 0.34)]; there was a significant difference in comparing the spontaneous bowel movements per week between deep acupuncture at Tianshu (ST 25) and Western medication [MD =0.53, 95% CI (0.13, 0.92)], but the difference was insignificant according to the sensitivity analysis [MD=0.38, 95% Cl (-0.03, 0.80)], indicating the low reliability of the conclusion. Regarding the Cleveland clinic score (CCS), the difference between shallow acupuncture at Tianshu (ST 25) and Western medication was insignificant [MD = 0.39, 95% Cl (-1.13, 1.91)]; the difference between deep acupuncture at Tianshu (ST 25) and Western medication was significant [MD=2.64, 95% Cl (1.32, 3.97)]. In the evaluation of security, the incidence rate of adverse events in acupuncture treatment (0.31%) was significantly lower than that in Western medication treatment (3.4%). Conclusion: Although the present systematic review showed that deep acupuncture at Tianshu (ST 25) should have better therapeutic efficacy than Western medication, the reliability and quality of the evidences were poor, and thus the above results require proving by more RCTs of higher quality.
基金Supported by Anhui Provincial Colleges science research platform team building program:2015TD033Provincial demonstrating experiment and practice training center:20100541
文摘Objective To systematically evaluate the efficacy of heat-sensitive moxibustion in treatment of cervical spondylotic radiculopathy(CSR). Methods Chinese National Knowledge Infrastructure(CNKI), China Biology Medical(CBM) database, Chinese Science and Technology Periodical Database(VIP), Wan Fang Data, Pubmed and Cochrane Library were retrieved to search the randomized controlled trials(RCT) on heat-sensitive moxibustion in treatment of CSR, and Meta analysis was conducted by applying Rev Man 5.3 software. Results Eventually, 10 papers were included in this study, including 1008 subjects. Meta analysis result showed: the total effective rate of treatment group was higher than that of control group, and the difference was statistically significant [RR=1.13, 95%CI(1.06, 1.21), Z=3.54, P=0.000 4]; the cure rate of treatment group was higher than that of control group, and the difference was statistically significant [RR=1.80, 95%CI(1.52, 2.13), Z=6.82, P〈0.000 01]; the improvement of short-form Mc Gill pain questionnaire(SF-MPQ) of treatment group was superior to that of control group, and the difference was statistically significant [MD=–4.44, 95%CI(–6.38,-2.50), Z=4.49, P〈0.000 01]; visual analogue scale(VAS) of treatment group was lower than that of control group, and the difference was statistically significant [MD=-0.36, 95%CI(-0.50, –0.23), Z=5.42, P〈0.00001]; and the improvement of interleukin-6(IL-6) of treatment group was superior to that of control group, and the difference was statistically significant [MD=–7.32, 95%CI(-11.49, –3.14), Z=3.44, P=0.000 6]. Conclusion It is indicated from the Meta analysis result that the clinical efficacy of heat-sensitive moxibustion or acupuncture combined with heat-sensitive moxibustion in treatment of CSR is superior to that of simple acupuncture or traditional suspended moxibustion, providing a new therapeutic method for treatment of CSR. However, the abovementioned conclusion still needs to be confirmed through randomized blind controlled trials with high quality and large sample size since the sample size of included studies was small, and the quality was low.
基金Supported by The National Key Basic Research And Development Plan(973 PlanNo.2011CB505100l)+1 种基金National Spleen-Stomach Diseases Key Clinical Specialist Construction ProjectsSpleen And Stomach Disease Key Discipline of State Administration of Traditional Chinese Medicine
文摘OBJECTIVE:To assess the efficacy of Traditional Chinese Medicine(TCM)on constipation-predominant irritable bowel syndrome by focusing on the liver.METHODS:Databases(domestic and foreign)were searched with the key words"irritable bowel syndrome","constipation",and"Chinese medicine";the relevant articles were retrieved and evaluated.Cure rate,"remarkable efficacy",recurrence rate and the incidence of adverse reactions were the outcome indicators.Review Manager ver 5.1 was used for this meta-analysis,and funnel plots used to detect publication bias.RESULTS:Nineteen randomized controlled trials were included and 1510 patients involved.The treatment guided byTCM based on the liver was superior to Western Medicine[odds ratio(OR)=2.46,95%confidence interval(CI)1.80,3.35)],cure rate[OR=2.61,95%CI(1.93,3.52)],remarkable efficacy[OR=2.68,95%CI(1.82,3.95)],recurrence rate[OR=0.19,95%CI(0.12,0.29)]and the incidence of adverse reactions[OR=0.24,95%CI(0.09,0.65)].However,funnel plots showed publication bias.CONCLUSION:Compared with Western Medicine,the treatment of IBS-C based on the liver is significantly better but the results must be treated with caution because publication bias was recorded.
文摘Objective:To observe the clinical effect of heat-sensitive moxibustion plus lactulose oral liquid for postoperative constipation of mixed hemorrhoid.Methods:A total of 70 patients were randomized into a treatment group and a control group,with 35 cases in each group by a random number table.Patients in the control group received lactulose oral liquid alone,while those in the treatment group received additional heat-sensitive moxibustion at Shenque(CV 8).The treatment was given once a day for 15 consecutive days.The defecation interval time,defecation duration,the scores of stool form,visual analog scale(VAS)and patient assessment of constipation quality of life questionnaire(PAC-QOL),as well as the serum substance P(SP)and nitric oxide(NO)levels were measured before and after treatment.Results:After treatment,the stool form score,defecation interval time and defecation duration in the two groups dropped significantly(all P<0.05),and they were lower in the treatment group than in the control group(all P<0.05).After treatment,the VAS scores in the two groups dropped significantly(both P<0.05),and it was lower in the treatment group than in the control group(P<0.05).After treatment,the PAC-QOL scores in the two groups dropped significantly(both P<0.05),and it was lower in the treatment group than in the control group(P<0.05).After treatment,the serum SP and NO levels in the two groups improved significantly(all P<0.05),and showed statistically significant differences between the treatment group and the control group(both P<0.05).Conclusion:Heat-sensitive moxibustion plus lactulose oral liquid can improve stool form,shorten defecation interval time and defecation duration,alleviate defecation pain,and improve quality of life(QOL)for patients with postoperative constipation of mixed hemorrhoid,which may be related to the regulation of the SP and NO levels.