大承气汤治疗粘连性肠梗阻临床疗效的Meta分析  

Meta-analysis of clinical efficacy of Dachengqi Decoction in treatment adhesive intestinal obstruction

作　　者：程华初 徐琦[2] 杨茜芸[1] 闫云云[1] 谭达全[1] CHENG Huachu;XU Qi;YANG Qianyun;YAN Yunyun;TAN Daquan(Hunan University of Chinese Medicine,Changsha,Hunan 410208,China;Hunan Academy of Traditional Chinese Medicine,Changsha,Hunan 410006,China)

机构地区：[1]湖南中医药大学,湖南长沙410208 [2]湖南省中医药研究院,湖南长沙410006

出　　处：《湖南中医药大学学报》2022年第6期966-973,共8页Journal of Hunan University of Chinese Medicine

基　　金：湖南中医药大学2017—2018年校级科研基金项目(31号)。

摘　　要：目的采用Meta分析方法系统评价大承气汤治疗粘连性肠梗阻的临床疗效,并对研究结果进行Grade证据级别评价。方法计算机检索PubMed、Embase、Web of Science、Cochrane Library、中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方数据(WanFang Data)和维普中文科技期刊数据库(VIP),收集有关大承气汤治疗粘连性肠梗阻的随机对照试验;检索年限为2000年1月至2021年12月;由2名评价者按照研究的纳入、排除标准筛选文献,并使用Cochrane系统评价的偏倚风险评价工具对纳入研究进行方法学质量评价;采用Review Manager 5.4软件进行Meta分析。结果共纳入文献25篇,2583例患者,其中治疗组1314例,对照组1269例。Meta分析结果显示,治疗组在总有效率[RR=1.23,95%CI(1.18,1.29),P<0.01]、恢复排气时间[SMD=-3.24,95%CI(-4.14,-2.35),P<0.01]、恢复排便时间[SMD=-2.70,95%CI(-3.65,-1.75),P<0.01]、肠鸣音恢复时间[SMD=-2.68,95%CI(-3.61,-1.75),P<0.01]、腹部症状消失时间[SMD=-1.70,95%CI(-2.14,-1.26),P<0.01]、气液平面消失时间[SMD=-1.18,95%CI(-1.48,-0.88),P<0.01]、饮食恢复时间[SMD=-1.71,95%CI(-2.44,-0.98),P<0.01]、住院时间[SMD=-1.97,95%CI(-2.49,-1.45),P<0.01]方面均优于对照组,差异有统计学意义;2组不良反应发生情况比较,差异无统计学意义[RR=0.69,95%CI(0.16,2.91),P>0.05]。结论在常规西医治疗的基础上联合大承气汤治疗粘连性肠梗阻,可提高临床有效率,促进患者排气、排便、肠鸣音及饮食的恢复,进一步改善临床症状,缩短住院时间,且不良反应小,其疗效优于西医常规基础治疗。Objective To systematically evaluate the clinical efficacy of Dachengqi Decoction in the treatment of adhesive intestinal obstruction by the method of Meta-analysis,and to conduct the Grade evidence-level evaluation on the research results.Methods The PubMed,Embase,Web of Science,Cochrane Library,CBM,CNKI,WanFang Data and VIP were retrieved by computer to collect the randomized controlled trials of Dachengqi Decoction in the treatment of adhesive intestinal obstruction.The search period was January 2000 to December 2021.Two evaluators screened the literature according to the inclusion and exclusion criteria and evaluated the methodological quality of the included studies using the bias risk assessment tool of the Cochrane Systematic Review.Meta-analysis was performed using Review Manager 5.4 software.Results A total of 2583 patients were included in 25 literatures,including 1314 patients in the treatment group and 1269 patients in the control group.Meta-analysis showed:in the treatment group,the total effective rate[RR=1.23,95%CI(1.18,1.29),P<0.01],fart recovery time[SMD=-3.24,95%CI(-4.14,-2.35),P<0.01],defecate recovery time[SMD=-2.70,95%CI(-3.65,-1.75),P<0.01],intestinal sounds recovery time[SMD=-2.68,95%CI(-3.61,-1.75),P<0.01],abdominal symptoms disappear time[SMD=-1.70,95%CI(-2.14,-1.26),P<0.01],gas-liquid flat disappeared time[SMD=-1.18,95%CI(-1.48,-0.88),P<0.01],diet recovery time[SMD=-1.71,95%CI(-2.44,-0.98),P<0.01],length of hospital stay[SMD=-1.97,95%CI(-2.49,-1.45),P<0.01]were better than the control group,the difference was statistically significant.There was no significant difference in the incidence of adverse reactions between the two groups[RR=0.69,95%CI(0.16,2.91),P>0.05].Conclusion On the basis of conventional western medicine basic treatment combined with Dachengqi Decoction for the treatment of adhesive intestinal obstruction,can improve the clinical efficiency,promote the recovery of patients’fart,defecation,intestinal sounds and diet,further improve the clinical symptoms,shorten the length

关 键 词：粘连性肠梗阻 大承气汤 随机对照试验 META分析 饮食 肠鸣音 排便 排气 

分 类 号：R259[医药卫生—中西医结合]