从脾肾阳虚辨治腹泻型肠易激综合征Meta分析  

Meta-analysis of Treating Diarrhea Irritable Bowel Syndrome from Yang Deficiency of Spleen and Kidney

作　　者：解坤 刘维明[2] 李海燕[1] XIE Kun;LIU Weiming;LI Haiyan(Shandong University of Traditional Chinese Medicine,Jinan 250014,Shandong,China;Jinan Hospital of Traditional Chinese Medicine Affiliated to Shandong University of Traditional Chinese Medicine,Jinan 250012,Shandong,China)

机构地区：[1]山东中医药大学,山东济南250014 [2]山东中医药大学附属济南市中医医院,山东济南250012

出　　处：《实用中医内科杂志》2020年第12期74-79,共6页Journal of Practical Traditional Chinese Internal Medicine

基　　金：济南市科技发展计划(201112009)。

摘　　要：目的探讨从脾肾阳虚辨治腹泻型肠易激综合征(IBS-D)相关方剂的有效性和安全性,为临床应用提供循证学依据。方法检索中国知网(CNKI)、中国生物医学文献数据库(CBM)、重庆维普全文期刊数据库(VIP)、万方数据库,查找从脾肾辨治IBS-D的临床随机对照试验(RCTs)。根据设定的纳入与排除标准筛选文献,用Cochrane系统评价方法对文献进行偏倚风险评估并提取有效数据,运用Rev Man 5.3软件进行Meta分析。结果共纳入13篇符合要求的文献,Meta分析结果显示:从脾肾阳虚辨治IBS-D相关方剂临床有效率高于对照组(OR=3.22,95%CI[2.32,4.48]),P <0.000 01。结论从脾肾阳虚辨治IBS-D相关方剂在改善腹泻、腹痛等症状、以及患者的生活质量、降低复发率等方面均优于西药常规治疗。但是,因纳入RCTs研究方法学质量不高、报道复发率较少、中医辨证分型存在差异、症状评估参差不齐等情况,导致纳入文献偏倚风险高,故结论尚需更多大样本、多中心、高质量的临床随机对照试验进一步验证。Objective To explore the effectiveness and safety of related prescriptions for diarrhea-predominant irritable bowel syndrome (IBS-D) based on syndrome differentiation and treatment of Yang deficiency of spleen and kidneyso as to provide evidence-based basis for clinical application. Methods CNKI,CBM,VIP and Wanfang databases were searched for clinical randomized controlled trials (RCTs) to treat IBS-D from spleen and kidney. According to the set inclusion and exclusion criteria,literature was screened. Cochrane system evaluation method was used to evaluate the bias risk of literature and extract valid data. Rev Man 5. 3 software was used to perform Meta-analysis. Results A total of 13 pieces of eligible literature were included. Meta-analysis results showed that the clinical effective rate of IBS-D related prescriptions based on syndrome differentiation of Yang deficiency of spleen and kidney was higher than that of the control group (or = 3. 22,95% CI[2. 32,4. 48]),P < 0. 000 01. Conclusion IBS-D related prescriptions based on syndrome differentiation and treatment of Yang deficiency of spleen and kidney are superior to conventional western medicine on relieving diarrhea,abdominal pain and other symptomsas well as improving the quality of life of patients and reducing recurrence rate. However,due to the low quality of RCTs research methodology,less reported recurrence rate,differences in TCM syndrome differentiation types and uneven symptom evaluation,the risk of inclusion literature bias is high,and so the conclusion needs to be further verified by more large-sample,multi-center,high-quality clinical randomized controlled trials.

关 键 词：脾肾阳虚 腹泻型肠易激综合征 随机对照试验 META分析 

分 类 号：R259[医药卫生—中西医结合]