调和肝脾中医经典方剂治疗腹泻型肠易激综合征疗效网状Meta分析  

Efficacy of Traditional Chinese Medicine Formulas for Regulating Liver and Spleen in the Treatment of Diarrheal-Predominant Irritable Bowel Syndrome:A Network Meta-analysis

作　　者：乔娜丽 李宁宁 黄冠华 袁宝健 QIAO Nali;LI Ningning;HUANG Guanhua;YUAN Baojian(Henan Second Provincial People's Hospital,Zhengzhou Henan 451191,China;Henan Medical College,Zhengzhou Henan 451191,China)

机构地区：[1]河南省第二人民医院,河南郑州451191 [2]河南医学高等专科学校,河南郑州451191

出　　处：《新中医》2023年第24期14-23,共10页New Chinese Medicine

摘　　要：目的:通过网状Meta分析(NMA)比较不同具有调和肝脾作用的中医经典方剂治疗腹泻型肠易激综合征(IBS-D)的疗效。方法:检索中国知网(CNKI)及PubMed等7个中英文数据库从建库起至2022年12月有关调和肝脾类中医经典方剂治疗IBS-D的随机对照试验(RCT)。使用R语言软件中的GeMTC包进行统计分析。结果:共纳入52项RCT,所有研究均以常规西药为对照措施,涉及8种中医经典方剂干预措施,NMA结果显示,合方治疗优于单方治疗,各干预措施成为最佳的概率排序如下:痛泻要方合柴胡疏肝散(84.5%)>柴胡疏肝散(75.8%)>痛泻要方合参苓白术散(64.1%)>痛泻要方合四逆散(63.7%)>痛泻要方合常规西药(56.1%)>四逆散(45.4%)>痛泻要方合四君子汤(45.0%)>痛泻要方(15.5%)>常规西药(0)。在不良反应方面中药具有良好的安全性。结论:痛泻要方合柴胡疏肝散可能为最佳治疗IBS-D的调和肝脾方剂。该研究尚存一定局限性,期待更多高质量的RCT研究予以验证。Objective:To compare the efficacy of different traditional Chinese medicine(TCM) formulas for regulating liver and spleen in the treatment of diarrheal irritable bowel syndrome(IBS-D) through Network Meta-analysis(NMA).Methods:Randomized controlled trials(RCT) on the treatment of IBS-D with TCM prescriptions for harmonizing liver and spleen were searched from seven Chinese and English databases including CNKI and PubMed from establishment to December 2022.The GeMTC package in R language software was used for statistical analysis.Results:A total of 52 RCT were included,all of which took conventional western medicine as the control measure,involving eight TCM intervention measures.NMA results showed that combination therapy was superior to single therapy,and the probability of each intervention becoming the best was ranked as follows:Tongxie Yaofang Decoction combined with Chaihu Shugan San(84.5%)>Chaihu Shugan San(75.8%)>Tongxie Yaofang Decoction combined with Shenling Baizhu San(64.1%) >Tongxie Yaofang Decoction combined with Sini San(63.7%) >Tongxie Yaofang Decoction combined with conventional western medicine(56.1%) >Sini San(45.4%) >Tongxie Yaofang Decoction combined with Sijunzi Decoction(45.0%) >Tongxie Yaofang Decoction combined with Sijunzi Decoction(45.0%) >Tongxie Yaofang Decoction(15.5%) >conventional western medicine(0).TCM has good safety in terms of adverse reactions.Conclusion;Tongxie Yaofang Decoction combined with Chaihu Shugan San may be the best prescription for regulating liver and spleen in treating IBS-D.This study still has some limitations,and more high-quality RCT studies are expected to verify it.

关 键 词：腹泻型肠易激综合征 中医经典方剂 调和肝脾 网状Meta分析 

分 类 号：R574.4[医药卫生—消化系统]