中药灌肠治疗溃疡性结肠炎的系统评价再评价  

Traditional Chinese Medicine Enema for the Treatment of Ulcerative Colitis:An Overview of Systematic Reviews

作　　者：薛玉娇 李毅 梁艳妮[3] 彭皞 张慧[1] 周长安 XUE Yu-jiao;LI Yi;LIANG Yan-ni;PENG Hao;ZHANG Hui;ZHOU Chang-an(Shaanxi University of Chinese Medicine,Xianyang Shaanxi 712000;First Digestion Department,Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang Shaanxi 712000;Collaborative Innovation Center of Traditional Chinese Medicine Resources Industrialization,Shaanxi University of Chinese Medicine,Xianyang Shaanxi 712000)

机构地区：[1]陕西中医药大学,陕西咸阳712000 [2]陕西中医药大学附属医院消化一科,陕西咸阳712000 [3]陕西中医药大学中药资源产业化协同创新中心,陕西咸阳712000

出　　处：《世界中西医结合杂志》2022年第12期2385-2391,2429,共8页World Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金项目(81803951);陕西省中药管理局项目(2019-ZZ-LC001)。

摘　　要：目的针对目前已发表的中药灌肠治疗溃疡性结肠炎的系统评价(Systematic review,SR)进行再评价,并进行报告质量和方法学质量评估,并对纳入文献的结局指标进行汇总分析,以期为临床工作者的决策提供更加科学可靠的循证依据。方法检索数据库PubMed、the Cochrane library、EMbase、CBM、CNKI、VIP、WanfangData,搜集中药灌肠治疗溃疡性结肠炎的系统评价/Meta分析,检索时间为建库至2021年11月4日。由两位研究员独立筛选文献及提取资料,并交叉核验。基于PRISMA报告清单、AMSTAR-2工具评估纳入研究的报告质量及方法学质量,并对结局指标进行汇总分析。结果共纳入21篇系统评价,共包含11类结局指标。PRISMA评分为13.5~24.5分,14篇(66.7%)报告相对完整,6篇(28.5%)报告存在一定的缺陷,1篇(4.8%)报告严重缺陷。AMSTAR-2评价结果提示完整报告率大于70.0%的条目有10个,低于50.0%的条目有6个,完整报告占总条目的37.5%,未报告占总条目的25.0%,整体质量偏低。在临床疗效、总有效率、镜下疗效及实验室指标等方面,与对照组相比,中药灌肠治疗可直达UC患者的病变部位,症状的改善、肠黏膜恢复的速度及程度均好于对照组;在复发率方面,中药灌肠治疗后的UC患者其数量和复发后病情程度明显低于对照组;在安全性方面,中药灌肠后UC患者的不良反应发生率均低于对照组,且多为轻度的胃肠道反应,差异均有统计学意义。结论中药灌肠治疗溃疡性结肠炎的疗效及安全性较好,但鉴于纳入文献的报告质量及方法学质量偏低,仍需更多高质量研究验证。Objective To re-evaluate the published systematic reviews(SRs)of traditional Chinese medicine(TCM)enema for ulcerative colitis(UC),evaluate the report quality and methodological quality,and summarize and analyze the outcome indicators included in the literature,so as to provide more scientific and reliable evidence-based references for clinicians to make decisions.Methods The SRs/Meta-analyses regarding TCM enema for the treatment of UC were retrieved from PubMed,Cochrane Library,EMbase,CBM,CNKI,VIP,and Wanfang Data from database inception to November 2021.Two investigators independently screened the literature and extracted data,followed by cross-checking.Based on PRISMA checklist and AMSTAR 2,the report quality and methodological quality of the included research were evaluated,and the outcome indicators were summarized and analyzed.Results Twenty-one SRs were included,including 11 categories of outcome indicators.The PRISMA score ranged from 13.5 points to 24.5 points.Fourteen reports(66.7%)were relatively complete,six reports(28.5%)had certain defects,and one report(4.8%)had serious defects.The results of AMSTAR 2 evaluation showed that there were 10 items with complete report rate greater than 70.0%and six items with complete report rate less than 50.0%.Complete reports accounted for 37.5%of the total items,and unreported ones accounted for 25%of the total items,so the overall quality was low.In terms of clinical efficacy,total effective rate,microscopic efficacy,and laboratory indexes,compared with the control group,TCM enema could directly act the lesion site of UC patients and show superior improvement of symptoms and speed and degree of intestinal mucosa recovery.In terms of recurrence rate,the number of UC patients treated by TCM enema and the degree of disease after recurrence were lower thanthose in the control group.In terms of safety,the incidence of adverse reactions in UC patients after TCM enema was lower than that in the control group,and most of them were mild gastrointestinal reactions,with sta

关 键 词：中药 灌肠 溃疡性结肠炎 系统评价 META分析 PRISMA AMSTAR-2 

分 类 号：R574.62[医药卫生—消化系统]