补中益气汤加减联合穴位贴敷治疗功能性便秘临床疗效和安全性的meta分析  

A meta-analysis of the clinical efficacy and safety of combining Buzhong Yiqi Decoction with acupoint application in treating functional constipation

作　　者：蔡舒雨 孙博云 何友成 蒋风茹 周淳宇 袁建业[1] CAI Shuyu;SUN Boyun;HE Youcheng;JIANG Fengru;ZHOU Chunyu;YUAN Jianye(Clinical Research Unit,Longhua Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai,200032,China)

机构地区：[1]上海中医药大学附属龙华医院临床研究中心,上海200032

出　　处：《中国中西医结合消化杂志》2023年第11期868-873,共6页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：上海市“科技创新行动计划”医学创新研究专项项目(No:21Y11922600);上海中医药大学附属龙华医院龙医学者(育苗)计划(No:Y21008)。

摘　　要：目的:系统评价补中益气汤加减联合穴位贴敷治疗功能性便秘的临床疗效和安全性。方法:检索中国知网、万方、维普、中国生物医学文献数据库、Embase数据库、PubMed数据库中有关补中益气汤加减联合穴位贴敷治疗功能性便秘的随机对照试验(randomized controlled trial,RCT),检索时限为建库至2023年7月5日。运用RevMan 5.4软件进行meta分析。结果:共检索文献44篇,最终纳入9篇文献,共752例患者。Meta分析结果显示,试验组总有效率、治愈率和外周血胃动素水平均高于对照组(RR=1.25,95%CI:1.17~1.34,P<0.001;RR=1.74,95%CI:1.40~2.18,P<0.001;MD=8.69,95%CI:7.40~9.99,P<0.001);试验组的排便难度评分、排便速度评分、大便性状评分、外周血胃泌素与生长抑素水平均低于对照组(SMD=-1.46,95%CI:-2.70~-0.22,P=0.02;SMD=-1.33,95%CI:-2.47~-0.19,P=0.02;SMD=-2.03,95%CI:-3.61~-0.44,P=0.01;MD=-6.45,95%CI:-8.31~-6.40,P<0.001;MD=-5.58,95%CI:-6.18~-4.98,P<0.001);两组排便间隔时间评分和不良反应发生率比较差异无统计学意义(MD=-0.28,95%CI:-0.89~0.32,P=0.36;OR=0.56,95%CI:0.28~1.10,P=0.09)。结论:补中益气汤加减联合穴位贴敷能有效提高功能性便秘的临床疗效,改善排便相关症状及胃肠功能,且安全性较好。Objective:To systematically evaluate the clinical efficacy and safety of Buzhong Yiqi Decoction with acupoint application in the treatment of functional constipation.Methods:Two independent researchers electronically searched databases,including CNKI,Wanfang,VIP,Chinese biomedical literature search database,Embase,PubMed,to collect randomized controlled trial(RCT)about Buzhong Yiqi Decoction combined with acupoint application in the treatment of functional constipation from the establishment time of the library to July 5,2023.Using RevMan 5.4software for meta-analysis and outcome index classification.Results:A total of 44articles were searched,and 9were ultimately included,covering 752patients.The results of meta-analysis showed that the total effective rate,the cure rate,and the peripheral blood motilin index level in the experimental group were higher than those of the control group(RR=1.25,95%CI:1.17-1.34,P<0.001;RR=1.74,95%CI:1.40-2.18,P<0.001;MD=8.69,95%CI:7.40-9.99,P<0.001),the defecation difficulty scores,the defecation speed scores,the stool character scores,the peripheral blood gastrin index level and the somatostatinlevelwere lower than those of the control group(SMD=-1.46,95%CI:-2.70--0.22,P=0.02;SMD=-1.33,95%CI:-2.47--0.19,P=0.02;SMD=-2.03,95%CI:-3.61--0.44,P=0.01;MD=-6.45,95%CI:-8.31--6.40,P<0.001;MD=-5.58,95%CI:-6.18-4.98,P<0.001),and there was no statistically significant difference in the score of defecation interval time and incidence of adverse reactions(MD=-0.28,95%CI:-0.890-0.32,P=0.36;OR=0.56,95%CI:0.28-1.10,P=0.09).Conclusion:The combination of Buzhong Yiqi Decoction and acupoint application can effectively improve the clinical effi cacy of functional constipation,improve defecation related symptoms and gastrointestinal function with good safety.

关 键 词：功能性便秘 补中益气汤 穴位贴敷 META分析 

分 类 号：R256.35[医药卫生—中医内科学]