中药内服联合手术治疗直肠前突疗效的Meta分析  

Meta-analysis of the efficacy of oral administration of traditional Chinese medicine combined with surgery in the treatment of rectocele

作　　者：吴莎 李亚玲 李涛 李俊 WU Sha(School of Integrated Traditional Chinese and Western Medicine,Southwest Medical University,Luzhou 646000,China)

机构地区：[1]西南医科大学中西医结合学院,四川泸州646000 [2]西南医科大学附属医院肛肠痔瘘科,四川泸州646000 [3]西南医科大学附属医院药学部,四川泸州646000

出　　处：《牡丹江医学院学报》2023年第2期108-113,共6页Journal of Mudanjiang Medical University

基　　金：四川省教育厅重点项目(SCYG2019-04);西南医科大学科研一般项目(SMUSS202212)。

摘　　要：目的运用Meta分析系统评价中药内服联合手术治疗直肠前突的临床疗效,为临床上中西结合治疗直肠前突提供循证依据。方法计算机检索中国知网、维普、万方、中国生物医学文献数据库、PubMed、Embase以及Cochrane Library等数据库。检索时限为各数据库建库至2021年10月1日,检索所有关于中药内服联合手术治疗直肠前突的随机对照试验(randomized controlled trial RCT),由2名研究员严格按照纳入、排除标准独立提取资料,并根据Cochrane手册5.1.0评价纳入文献质量后采用RevMan 5.4软件进行Meta分析。结果最终纳入14篇文献,共计979例样本,均为女性患者。Meta分析结果显示:(1)试验组的总有效率明显高于对照组[OR=2.96,95%CI(1.72,5.10),P<0.0001],差异有显著统计学意义;(2)试验组术后longo’s IDS便秘评分[SMD=-0.41,95%CI(-0.67,-0.15),P=0.002]、术后并发症发生率[OR=0.47,95%CI(0.28,0.79),P=0.004]、复发率[OR=0.11,95%CI(0.02,0.63),P=0.01]均低于对照组,差异有统计学意义。结论中药内服联合手术治疗直肠前突的临床疗效明显优于单一手术治疗,能有效降低术后并发症的发生率、复发率,改善直肠前突所致的便秘症状,但在手术及住院时间上无明显差异。受纳入文献质量和数量的限制,该结论还需更多大样本量、多中心、高质量的RCT来进一步验证。Objective The Meta-analysis system was used to evaluate the clinical efficacy of oral administration of traditional Chinese medicine combined with surgery in the treatment of rectocele,and to provide evidence-based basis for the clinical treatment of rectocele with integrated Chinese-western therapy.Methods Databases such as CNKI,VIP,Wan Fang Data,CMB,Pubmed,Embase and Cochrane Library were searched by computer.The retrieval time limit was from the establishment of each database to October 1,2021.All randomized controlled trials(RCTs)on the treatment of rectal prolapse by oral administration of traditional Chinese medicine combined with surgery were retrieved.Two researchers independently extracted data in strict accordance with the inclusion and exclusion criteria,and evaluated the quality of the included literature based on the Cochrane Handbook 5.1.0.RevMan 5.4 software was used for meta-analysis of all included studies.Results A total of 979 samples from 14 literatures were finally included,all of which were female patients.Meta-analysis results showed that:①the total effective rate of the experimental group was significantly higher than that of the control group[OR=2.96,95%CI(1.72,5.10),P<0.0001],and the difference was statistically significant.②the postoperative longo's IDS constipation score[SMD=-0.41,95%CI(-0.67,-0.15),P=0.002],postoperative complication rate[OR=0.47,95%CI(0.28,0.79),P=0.004],and recurrence rate[OR=0.11,95%CI(0.02,0.63),P=0.01]in experimental group were lower than those of the control group,and the differences were statistically significant.Conclusion he clinical efficacy of oral administration of traditional chinese medicine combined with surgery in the treatment of rectocele is significantly better than that of single surgery,which can effectively reduce the incidence of postoperative complications,recurrence rate,and improve constipation symptoms caused by rectocele,but there is no difference in operation and hospitalization time.Limited by the quality and quantity of the included

关 键 词：中药内服 手术治疗 联合疗法 直肠前突 META分析 

分 类 号：R657.1[医药卫生—外科学]