以痛泻要方为基本方治疗肝郁脾虚型肠易激综合征临床疗效的系统评价  

Systematic Review of the Efficacy of Tongxie Yaofang in Treating Irritable Bowel Syndrome of Liver Stagnation Type

作　　者：王咏梅 时亚娟[2] 王维国 Wang Yongmei Shi Yajuan Wang Weiguo(Dezhou Mulnicipal Hospital, Dezhou 253016, China Tianjin University of Chinese Medicine, Tianjin 300193, China)

机构地区：[1]山东省德州市市立医院消化内科,德州253016 [2]天津中医药大学,天津300193

出　　处：《世界中医药》2017年第9期2223-2227,2231,共6页World Chinese Medicine

摘　　要：目的:对以痛泻要方为基本方治疗肝郁脾虚型肠易激综合征的疗效及安全性进行系统评价及Meta分析。方法:通过计算机检索中国生物医学文献数据库(CBM)、中国期刊全文数据库(CNKI)、中国科技期刊全文数据库(VIP)、万方数据库(WANFANG)、EMbase、Pub Med、Cochrane Library,检索时限为建库至2015年12月。全面收集以痛泻要方为基本方治疗肝郁脾虚型肠易激综合征的随机对照试验。由两名研究者独立选择试验、提取数据、评价质量,并进行交叉核对。采用Cochrane协作网提供的Reve Man5.3.3软件进行Meta分析。结果:共纳入26个随机对照试验,2 694例患者。"漏斗图"呈不对称分布,提示可能存在发表偏移或纳入研究方法学质量偏低。Meta分析结果显示:1)以痛泻要方为基本方的中药能够改善肝郁脾虚型肠易激综合征患者的临床症状,其疗效[总有效率OR=5.16,95%CI(4.05,6.58),痊愈率OR=2.75,95%CI(2.24,3.36)]优于西药治疗;2)8组不良事件发生率明显低于对照组,3组复发率[复发率OR=0.29,95%CI(0.14,0.61)]低于对照组。结论:以痛泻要方为基本方治疗肝郁脾虚型肠易激综合征有明显的疗效。但由于纳入研究的方法学质量偏低以及可能存在发表偏倚,上述结论有待进一步开展大样本、高质量、多中心的随机双盲对照试验来证实。Objective To assess the efficacy and safety of treating irritable bowel syndrome（ IBS） of liver stagnation type with Tongxie Yaofang. Methods： To collect RCTs of treating IBS with Tongxie Yaofang by computer from databases include CBM,CNKI,VIP,WANFANG,EMbase,Pub Med and Cochrane Library. The date is from the founding time of the database to December 2015.The RCTs were chosen independently,data was extracted and the quality was evaluated and cross checked by two researchers,using Review Manger 5. 3. 3 software,produced by Cochrane. Results： A total of 26 trials were included with 2694 patients. Funnel plot is asymmetric distribution,suggesting that there may be a publication bias or inclusion in the study method of low quality. Meta analysis results show that Tongxie Yaofang can improve clinical symptoms of liver stagnation and spleen deficiency in patients with IBS and had higher total effective rate than the control medicine [Total efficiency rate OR = 5. 16,95% CI（ 4. 05,6. 58）; Cure rate OR= 2. 75,95% CI（ 2. 24,3. 36） ]. The incidence of adverse events in the 9 groups was significantly lower than that of the control group. The recurrence rate of the 4 groups was lower than that of the control group[recurrence rate OR = 0. 29,95% CI（ 0. 14,0. 61） ]. Conclusion： Tongxie Yaofang has obvious effect in the treatment of liver stagnation and spleen deficiency type of IBS.However,due to the low methodological quality of included studies and possible publication bias,the above conclusions need to be further proved with large sample,high quality and multi center randomized double blind controlled trials.

关 键 词：痛泻要方 肝郁脾虚型 肠易激综合征 IBS 系统评价 

分 类 号：R242[医药卫生—中医临床基础]