摘要
目的:系统评价柴胡疏肝散加减对比常规西药治疗肠易激综合征的临床疗效,旨在为临床用药提供循证参考。方法:计算机检索中国知网、维普、万方、PubMed、Embase、the Cochrane Library等数据库,时限从建库至2021年2月。由2位研究员依据纳入标准独立甄选文献,收集柴胡疏肝散(试验组)对比常规西药组(对照组)的随机对照试验和病例对照研究。筛选文献,提取资料后,采用Cochrane系统评价员手册5.1.0推荐的偏倚风险评估工具对随机对照试验进行质量评价,采用RevMan 5.3进行Meta分析,TSA 0.9进行试验序贯分析,Stata 15.0进行发表偏倚评估,GRADEprofiler 3.6进行证据质量评价。结果:纳入7项研究,总样本量538例。Meta分析结果显示,柴胡疏肝散治疗肠易激综合征的临床治愈率和总有效率均高于常规西药(P<0.001),以肠易激综合征腹泻型和便秘型为依据进行亚组分析的结果显示,柴胡疏肝散对腹泻型肠易激综合征(P=0.002)和便秘型肠易激综合征(P=0.03)的临床总有效率均显著高于对照组。按试验序贯分析显示柴胡疏肝散治疗肠易激综合征临床总有效率证据确切。Harbord回归显示不存在发表偏倚(P=0.49)。证据质量评价显示两项指标的证据质量均为低,推荐强度为弱推荐。结论:柴胡疏肝散治疗肠易激综合征的临床疗效优于常规西药,具有临床应用的潜力。
Objective:To systematically evaluate the clinical efficacy of the Chaihu Shugan powder(柴胡疏肝散)compared with conventional Western medicine on irritable bowel syndrome.Methods:The related literature was searched in databases such as CNKI,VIP,Wanfang,PubMed,Embase,the Cochrane Library,etc..The time limit was from the establishment of the database to February 2021.Two researchers independently selected literature based on the inclusion criteria,and collected randomized controlled trials and casecontrol studies of the Chaihu Shugan powder(the experimental group)versus conventional Western medicine group(the control group)o the disease.After screening the literature and extracting the data,the quality of RCTs were evaluated by the bias risk assessment tool recommended by Cochrane System Reviewer Manual 5.1.0,a Meta-analysis was performed by RevMan 5.3,a trial sequential analysis was performed by TSA 0.9,and publication bias assessment was performed by Stata 15.0,and the quality of evidence was assessed by GRADEprofiler 3.6.Results:Seven studies were included,with a total sample size of 538 cases.The Meta-analysis results show that the clinical cure rates of the Chaihu Shugan powder on irritable bowel syndrome and total efficiency were higher than those of conventional Western medicines.The results of subgroup analysis based on IBS diarrhea and constipation types show that the Chaihu Shugan powder was associated with diarrhea-type irritable bowel syndrome(P=0.002)and constipation-type irritable bowel syndrome(P=0.03).The clinical total efficiency was significantly higher than the control group.The sequential analysis of trials showed that the clinical total efficiency of the Chaihu Shugan powder on IBS was confirmed.Harbord regression showed that there was no publication bias(P=0.49).The evaluation of the quality of evidence showed that the quality of the evidence for the two indicators was low,and the recommendation strength was weak.Conclusion:The Chaihu Shugan powder was superior to conventional Western medi
出处
《中医临床研究》
2022年第4期145-148,共4页
Clinical Journal Of Chinese Medicine
基金
国家自然科学基金项目(81603634)
国家中医药管理局“国医大师熊继柏传承工作室”项目(04-19-02)
湖南省教育厅科学研究重点项目(19A373)
湖南省中医药科研计划项目(2021022)。
关键词
柴胡疏肝散
肠易激综合征
META分析
试验序贯分析
The Chaihu Shugan powder
Irritable bowel syndrome
Meta-analysis
Trial sequential analysis
