氟哌噻吨美利曲辛治疗慢性便秘有效性与安全性的系统评价  

Systematic review of efficacy and safety of flupenthixol melitracen for chronic constipation

作　　者：王诗棋 辛学知[2] 张婷[1] 吴可 张雅琦 粟裕冬 WANG Shi-qi;XIN Xue-zhi;ZHANG Ting(Shandong University of traditional Chinese medicine,Jinan 250014,China)

机构地区：[1]山东中医药大学,济南250014 [2]山东省千佛山医院,济南250014

出　　处：《中国处方药》2023年第10期11-16,共6页Journal of China Prescription Drug

基　　金：齐鲁医派中医学术流派建设项目(山东辛氏肛肠中医药特色技术)(鲁卫函[2020]132号);山东省名老中医专家辛学知传承工作室(鲁卫函[2020]92号)。

摘　　要：目的 系统评价氟哌噻吨美利曲辛治疗慢性便秘临床疗效和安全性。方法 计算机检索Pub Med、Web of Science、中国知网(CNKI)、中国生物医学文献数据库(CBM)、维普(VIP)、万方(Wan Fang)、美国临床试验数据库(Clinical Trials)和中国临床试验注册中心数据库(Chinese Clinical Trial Registry),搜集有关氟哌噻吨美利曲辛治疗慢性便秘的随机对照试验(RCTs),检索时限均从建库至2022年11月13日。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Rev Man 5.4和Stata MP 14软件进行Meta分析。结果共纳入17篇文献,涉及1 428例慢性便秘患者。Meta分析结果显示,联合使用氟哌噻吨美利曲辛治疗慢性便秘与单独使用便秘常用药物相比,总有效率[OR=3.66,95%CI=(2.76,4.85),P <0.05]更高,改善排便困难[OR=-0.82,95%CI=(-1.34,-0.29),P <0.05]、排便频率[OR=-1.50,95%CI=(-2.45,-0.55),P <0.05]、粪便性状[OR=-1.05,95%CI=(-1.59,-0.51),P <0.05]和焦虑[OR=-3.37,95%CI=(-5.03,-1.71),P <0.05]、抑郁[OR=-4.60,95%CI=(-6.91,-2.29),P <0.05]症状的疗效更优,但不良反应发生率[OR=2.05,95%CI=(1.09,3.88),P <0.05]更高。结论 氟哌噻吨美利曲辛治疗慢性便秘比单独使用便秘常用药物有效率更高,改善患者便秘和精神症状更佳,而不良反应发生率可能也更高。受纳入研究的质量限制,上述结论尚待更多高质量研究予以验证。Objective To systematically evaluate the efficacy and safety of flupenthixol melitracen in the treatment of chronic constipation(CC).Methods The PubMed,Web of Science,CNKI,CBM,VIP,WanFang,Clinical Trials and Chinese Clinical Trial Registry databases were electronically searched to collect randomized controlled trials(RCTs)on flupenthixol melitracen for CC from the establishment of the database till 13 November 2022.Two researchers independently screened literature,extracted data and assessed the risk of bias of included studies.RevMan5.4 and StataMP 14 softwares were used for meta-analysis.Results A total of 17 studies were included,involving 1428 patients with CC.The results of meta-analysis showed that compared with common drugs for constipation,combined with flupenthixol melitracen had higher total effective rate[OR=3.66,95%CI=(2.76~4.85),P<0.05],the improvement in bowel difficulties[OR=-0.82,95%CI=(-1.34~-0.29),P<0.05],bowel frequency[OR=-1.50,95%CI=(-2.45~-0.55),P<0.05],fecal character(OR=-1.05,95%CI=(-1.59~-0.51),P<0.05),anxiety[OR=-3.37,95%CI=(-5.03~-1.71),P<0.05]and depression[OR=-4.60,95%CI=(-6.91~-2.29),P<0.05]symptoms were more efficacious,but higher incidence of adverse reactions[OR=2.05,95%CI=(1.09~3.88),P<0.05].Conclusion The current evidence shows that,compared with common drugs for constipation alone,combined with flupenthixol melitracen had higher total effective rate,better improvement of patients'constipation and psychiatric symptoms and higher incidence of adverse reactions.Due to limited quality of the included studies,the above conclusions need to be verified by more high-quality studies.

关 键 词：慢性便秘 氟哌噻吨美利曲辛 META分析 系统评价 随机对照试验 

分 类 号：R969[医药卫生—药理学]