Systematic Review and Meta-analysis on the Efficacy and Safety of Changyanning Granules(肠炎宁颗粒)in Treating Diarrhea

Objective:To systemically evaluate the effectiveness and safety of Changyanning Granules(肠炎宁颗粒)combined with conventionally Western medicine in the treatment of diarrhea.Methods:Chinese and English database retrieval system:CNKI,Wanfang,VIP,Sinomed,Pub Med,Cochrane Library,Embase,and Web of Science screened out a randomized controlled trial(RCT)of Changyanning Granules in the treatment of diarrhea.Meta-analysis was performed on the included studies according to the Cochrane Handbook 5.1 evaluation criteria,tools and Rev Man 5.3 software.Results:A total of 5 studies were included,all of which were included in the Meta-analysis.The total sample size was 628 cases,with the maximum sample size of 240 cases and the minimum sample size of 78 cases,including 354 cases in the experiential group and 274 cases in the control group.Results of Meta-analysis showed that Changyanning Granules combined with conventional treatment,Changyanning Granules combined with Xiyanping Injection(喜炎平注射液)and conventional treatment,Changyanning Granules combined with smecta and conventional treatment were better than conventional treatment or Xiyanping Injection combined with conventional treatment(MD=-1.80,95%CI[-2.22,-1.38],P<0.00001).The antidiarrhoea time of Changyanning Granules combined with conventional treatment in the treatment of diarrhea was better than that of conventional treatment alone(MD=-1.70,95%CI[-1.89,-1.52],P<0.00001)when literatures with greater heterogeneity were removed.The IL-6 index of Changyanning Granules combined with conventional treatment in the treatment of diarrhea was better than that of conventional treatment alone(MD=-7.05,95%CI[-9.58,-4.52],P<0.00001).The effectiveness of Changyanning Granules combined with conventional treatment,Changyanning Granules combined with smecta and conventional treatment in the treatment of diarrhea was better than that of conventional treatment alone(RR=1.31,95%CI[1.16,1.47],P<0.0001).The adverse action rate of Changyanning Granules combined with conventional treatment,Changyanning Granules combined with smecta and conventional treatment in the treatment of diarrhea had no difference compared with conventional treatment alone(RR=2.50,95%CI[0.50,12.60],P=0.27).Adverse actions reported in the study included constipation,abdominal discomfort,nausea,and vomiting,and the incidence of reverse actions was similar between the experimental group and the control group.The number of reported ADR cases was relatively small,requiring further proof of large sample size.Conclusion:Based on the existing data and methods,the antidiarrhoea time,IL-6 index,time of absolute pain and significant efficiency of Changyanning Granules alone or combined with conventional treatment are better than conventional treatment alone in the treatment of diarrhea.Adverse actions,including nausea,vomiting,and dizziness,were reported in fewer cases and were less common in the experimental group than in the control group.However,due to the small number and low quality of the included research literatures,and the existence of certain bias,large sample and high quality literatures are needed for further verification.