口服中成药治疗腹泻型肠易激综合征的网状Meta分析  

Network Meta-analysis of oral Chinese patent medicine in treatment of irritable bowel syndrome with predominant diarrhea

作　　者：梁宇花 高霞 孟捷[1] IANG Yu-hua;GAO Xiao;MENG Jie(Dongfang Hospital Affiliated to Beijing University of Chinese Medicine,Beijing 100078,China)

机构地区：[1]北京中医药大学东方医院,北京100078

出　　处：《中草药》2023年第10期3237-3252,共16页Chinese Traditional and Herbal Drugs

基　　金：北京市科技计划项目(Z161100000516058);第四批全国中医(临床、基础)优秀人才研修项目(国中医药人教发[2017]24号)。

摘　　要：目的 运用基于贝叶斯框架的网状Meta分析方法评价口服中成药治疗腹泻型肠易激综合征的疗效及安全性。方法 计算机检索中国知网(CNKI)、万方数据库(Wanfang Data)、维普数据库(VIP)、中国生物医学文献数据库(CBM)、Pub Med、Embase、Web of Science、Cochrane Library数据库,检索有关口服中成药联合常规西医治疗(conventional western medicine treatment,CWMT)腹泻型肠易激综合征的临床随机对照试验,检索时限为自建库至2022年11月15日。采用Cochrance偏倚风险评估工具对纳入研究进行偏倚风险评价,使用Stata14.0和Ge MTC 0.14.3软件进行数据分析。结果 最终纳入51项研究,13种中成药,4468例患者。网状Meta分析结果显示,提高总有效率的前3种最佳方案为补中益气丸(颗粒)+CWMT>乌梅丸+CWMT>乌灵胶囊+CWMT;在改善腹痛积分方面,疗效前3名的方案依次为乌灵胶囊+CWMT>痛泻宁颗粒+CWMT>补脾益肠丸+CWMT=枫蓼肠胃康胶囊(颗粒/片)+CWMT;在改善腹泻积分方面,疗效前3名的方案依次为乌灵胶囊+CWMT>补脾益肠丸+CWMT>痛泻宁颗粒+CWMT;在改善腹胀积分方面,疗效前2名的方案为气滞胃痛颗粒+CWMT>乌灵胶囊+CWMT;在降低不良反应发生率方面,排名前3名的方案依次为补脾益肠丸+CWMT>参苓白术颗粒(散/丸)+CWMT>参倍固肠胶囊+CWMT。结论 与CWMT相比,联合口服中成药治疗腹泻型肠易激综合征可以提高总有效率,改善腹痛、腹泻、腹胀症状,且不会增加不良反应发生率。由于纳入文献质量水平不高,结论仍需更多高质量研究进一步验证。Objective To evaluate the efficacy and safety of oral Chinese patent medicine in the treatment of irritable bowel syndrome with predominant diarrhea(IBS-D)by using network Meta-analysis method based on Bayesian framework.Methods The randomized controlled trials of oral Chinese patent medicine combined with conventional western medicine treatment(CWMT)in the treatment of IBS-D were searched from databases such as CNKI,Wanfang Data,VIP,CBM,PubMed,Embase,Web of Science,Cochrane Library database by computer from establishment of the database to November 15,2022.The quality of the included studies was assessed by the risk bias assessment tool recommended by Cochrance and data was analyzed by Stata14.0 and GeMTC 0.14.3 software.Results A total of 51 studies were included,with 4468 patients,involving 13 oral Chinese patent medicines.The results of the network Meta-analysis showed that,in terms of improving the total effective rate,the top three therapeutic regimens were Buzhong Yiqi Pills(Granules)[补中益气丸(颗粒)]combined with CWMT>Wumei Pills(乌梅丸)with CWMT>Wuling Capsules(乌灵胶囊)combined with CWMT;In terms of improving the abdominal pain scores,the top three therapeutic regimens were Wuling Capsules combined with CWMT>Tongxiening Granules(痛泻宁颗粒)combined with CWMT>Bupi Yichang Pills(补脾益肠丸)combined with CWMT=Fengliao Changweikang Capsules(Granules/Pills)[枫蓼肠胃康胶囊(颗粒/片)]combined with CWMT;In terms of improving diarrhea scores,the top three therapeutic regimens were Wuling Capsules combined with CWMT>Bupi Yichang Pills combined with CWMT>Tongxiening Granules combined with CWMT;In terms of improving abdominal distension scores,the top two therapeutic regimens were are Qizhi Weitong Granules(气滞胃痛颗粒)combined with CWMT>Wuling Capsules combined with CWMT;In terms of reducing the incidence of adverse reactions,the top three therapeutic regimens were Bupi Yichang Pills combined with CWMT>Shenling Baizhu Granules(Powders/Pills)[参苓白术颗粒(散/丸)]comb

关 键 词：中成药 腹泻型肠易激综合征 网状Meta分析 贝叶斯模型 随机对照试验 参苓白术颗粒(散/丸) 补脾益肠丸 参倍固肠胶囊 固本益肠片 补中益气丸(颗粒) 枫蓼肠胃康胶囊(颗粒/片) 痛泻宁颗粒 固肠止泻丸 气滞胃痛颗粒 乌灵胶囊 肠炎宁糖浆(胶囊) 胃肠安丸 乌梅丸 

分 类 号：R285.64[医药卫生—中药学]