脐疗治疗溃疡性结肠炎效果的系统评价和Meta分析被引量：4

Effect of umbilical therapy on ulcerative colitis: a systematic evaluation and Meta-analysis

导出

摘要目的系统评价脐疗在成人溃疡性结肠炎中的应用效果。方法系统检索中英文数据库中与脐疗治疗溃疡性结肠炎效果有关的临床随机对照试验,并追溯其引用文献,检索时限为各数据库建库至2020年12月30日。由2名研究者依据纳排标准进行筛查、评价,提取相应文献资料和数据,并运用RevMan5.3软件进行Meta分析。结果最终纳入13篇中文文献,共计898例患者。Meta分析结果表明:常规治疗和单纯脐疗的治疗总体症状缓解率[RR=0.70,95%CI(0.12,4.19),P=0.70]和有效率[RR=0.93,95%CI(0.54,1.59),P=0.86]差异均无统计学意义;脐疗联合常规治疗能提高治疗有效率[RR=1.26,95%CI(1.18,1.35),P<0.00001]、总体症状缓解率[RR=1.94,95%CI(1.44,2.61),P<0.0001]、腹痛缓解率[RR=1.90,95%CI(1.42,2.54),P<0.0001]、腹泻缓解率[RR=1.32,95%CI(1.07,1.64),P=0.01]、脓血便缓解率[RR=1.22,95%CI(1.03,1.44),P=0.02]和减轻疾病活动度[MD=-1.79,95%CI(-3.37,-0.21),P=0.03],但在不良反应方面,两组差异无统计学意义[RR=0.33,95%CI(0.08,0.80),P=0.13]。结论单纯脐疗与常规治疗疗效相当,但脐疗联合常规治疗在提高治疗有效率、总体症状缓解率和改善临床症状的效果更好。由于受到纳入研究项目数量和质量的限制,尚需更多长期随访及大样本和设计严谨的随机对照研究予以证明。 Objective To systematically evaluate the effect of umbilical therapy in adult ulcerative colitis.Methods The clinical randomized controlled trials(RCT)related to the effect of umbilical therapy in ulcerative colitis in the Chinese and English databases were systematically searched,and their citations were traced.The search time limit was from the establishment of each database to December 30,2020.Two researchers screened and evaluated the articles according to the inclusion and exclusion criteria,and extracted article information and data.RevMan5.3 was used for meta-analysis.Results A total of 13 Chinese articles were included,with 898 patients.The results of meta-analysis showed that there was no statistically significant difference in the general symptom relief rate[RR=0.70,95%CI(0.12,4.19),P=0.70]and effective rate[RR=0.93,95%CI(0.54,1.59),P=0.86]between conventional therapy and umbilical therapy alone.Umbilical therapy combined with conventional therapy can improve the effective rate of treatment[RR=1.26,95%CI(1.18,1.35),P<0.00001],general symptom relief rate[RR=1.94,95%CI(1.44,2.61),P<0.0001],abdominal pain relief rate[RR=1.90,95%CI(1.42,2.54),P<0.0001],diarrhea relief rate[RR=1.32,95%CI(1.07,1.64),P=0.01],remission rate of pus and blood stool[RR=1.22,95%CI(1.03,1.44),P=0.02]and reduced disease activity[MD=-1.79,95%CI(-3.37,-0.21),P=0.03].In terms of adverse reactions,the difference between the two groups was not statistically significant[RR=0.33,95%CI(0.08,0.80),P=0.13].Conclusions The efficacy of umbilical therapy alone is equivalent to that of conventional therapy,but umbilical therapy combined with conventional therapy is more effective in improving the treatment effective rate,general symptom relief rate and clinical symptoms.Due to the limitation of the number and quality of the included studies,long-term follow-up,large sample and rigorous RCT studies are needed to prove it.

作者杨丹晏利姣麦秋露王斗张小艳郝玉芳郭海玲王芳 Yang Dan;Yan Lijiao;Mai Qiulu;Wang Dou;Zhang Xiaoyan;Hao Yufang;Guo Hailing;Wang Fang(School of Nursing,Beijing University of Chinese Medicine,Beijing 102448,China;Evidence-Based Medicine Center,Beijing University of Chinese Medicine,Beijing 100029,China;Department of Medical Insurance,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Evidence-Based Nursing Excellence Center of Joanna Briggs Institute,Beijing University of Chinese Medicine,Beijing 102448,China;Registered Nurses'Association of Ontario-Best Practice Spotlight Organizations Best Practice Guideline Research Center,Beijing University of Chinese Medicine,Beijing 102448,China;Department of Nursing,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China;Department of Brain Disease,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)