中医外治法治疗老年性便秘有效性的Meta分析  

Meta-analysis of Effectiveness of Traditional Chinese Medicine External Therapy for Treatment of Constipation in the Elderly

作　　者：胡思琴 赵喜颖[1] 张广清 丁美祝[1] 胡佩欣 黄楚君[1] HUSi-Qin;ZHAO Xi-Ying;ZHANG Guang-Qing;DING Mei-Zhu;HU Pei-Xin;HUANG Chu-Jun(The Second Clinical Medical School,Guangzhou University of Chinese Medicine,Guangzhou 510006 Guangdong,China;Southern Hospital of Southern Medical University,Guangzhou 510515 Guangdong,China)

机构地区：[1]广州中医药大学第二临床医学院,广东广州510006 [2]南方医科大学南方医院,广东广州510515

出　　处：《广州中医药大学学报》2021年第6期1198-1207,共10页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省科技厅资助项目(编号:2017ZC0169);广东省中医院中医药科学技术研究专项基金资助项目(编号:YN2018HL02)。

摘　　要：【目的】系统评价中医外治法治疗老年性便秘的有效性及安全性。【方法】计算机检索中国知网期刊全文数据库(CNKI)、万方数据知识服务平台(Wanfang)、维普数据库(VIP)、中国生物医学文献数据库(CBM)、美国医学在线(PubMed)、Embase、The Cochrane Library、Web of Science数据库中以中医外治法为主要疗法治疗老年性便秘的随机对照试验(RCT)的文献。采用Cochrane协作网推荐的质量评价工具对纳入文献进行质量评价,运用RevMan 5.3软件对纳入文献进行Meta分析。【结果】共纳入24篇RCT文献,包含1 908例患者。Meta分析结果显示,试验组治疗后总有效率(OR=4.07,95%CI=[3.09,5.36],P<0.05),便秘患者生活质量量表(OR=-11.86,95%CI=[-15.49,-8.22],P<0.05),症状积分(OR=-2.56,95%CI=[-4.25,-0.87],P<0.05),Bristol大便性状评分(OR=1.24,95%CI=[0.42,2.06],P<0.05),首次排便时间(OR=-4.23,95%CI=[-5.82,-2.64],P<0.05)疗效优于对照组,但周排便次数(OR=0.89,95%CI=[-1.75,3.52],P>0.05)疗效与对照组差异无统计学意义。【结论】中医外治法治疗老年性便秘具有良好的临床疗效,能够有效地提高临床总有效率,改善便秘患者的生活质量,提高患者的症状积分,Bristol大便性状评分,并加快首次排便时间;但在改善老年便秘患者的周排便次数方面,尚不能证实其有效性。仍需更多高质量大样本的临床随机对照试验予以证实。Objective To systematically evaluate the clinical efficacy and safety of traditional Chinese medicine(TCM)external therapy for constipation in the elderly. Methods We searched out the randomized controlled trials(RCTs)on TCM external therapy for constipation in the elderly from CNKI,Wanfang,VIP,CBM,PubMed,Embase,The Cochrane Library,Web of Science databases by computer. And then the included literatures were given quality evaluation by Cochrane tool, and Meta-analysis by RevMan 5.3 software. Results A total of 24 literatures on RCTs, including 1 908 patients, were included. Meta-analysis results showed that the total effective rate after treatment in the experimental group(OR = 4.07,95%CI = [3.09,5.36],P < 0.05),quality of life scores(PAC-QOL)(OR =-11.86,95 %CI = [-15.49,-8.22],P < 0.05),symptom scores(OR =-2.56,95%CI = [-4.25,-0.87],P < 0.05),Bristol stool form scores(OR = 1.24,95%CI = [0.42,2.06],P < 0.05),time to first defecate(OR =-4.23,95%CI = [-5.82,-2.64],P < 0.05)were superior to those in the control group. But there were no differences in number of weekly defecate(OR = 0.89,95%CI = [-1.75,3.52],P>0.05)between the two groups. Conclusion TCM external therapy is effective for the treatment of constipation in the elderly,which can effectively improve the total effective rate,improve the quality of life of the patients,enhance symptom scores and Bristol stool form scores,and accelerate time to first defecate,but in terms of improving the number of weekly defecate,the effectiveness has not been confirmed,so it needs to be verified by high-quality,big-sample RCTs yet.

关 键 词：中医外治法 老年性便秘 随机对照试验 META分析 生活质量 

分 类 号：R246.9[医药卫生—针灸推拿学]