目的:对中医药治疗肠易激综合征(irritable bowel syndrome,IBS)的系统评价/Meta分析进行再评价研究.方法:计算机检索Cochrane Library、PubMed、AMED、E M b a s e、C B M、C N K I、V I P和WanFang Data,收集中医药治疗IBS的系统评价/...目的:对中医药治疗肠易激综合征(irritable bowel syndrome,IBS)的系统评价/Meta分析进行再评价研究.方法:计算机检索Cochrane Library、PubMed、AMED、E M b a s e、C B M、C N K I、V I P和WanFang Data,收集中医药治疗IBS的系统评价/Meta分析文章,检索时限均从建库至2013-11.由2位研究者按照纳入标准独立筛选文献、提取资料后,采用AMSTAR评价纳入研究质量,同时采用GRADE系统对主要研究结果进行证据质量分级.结果:共纳入14个相关系统评价/Meta分析,10篇研究评价了中草药疗效,4篇研究评价了针灸疗法,AMSTAR评分在2-10分之间,再评价主要结果显示,中医药治疗IBS较常规西药具有一定优势,但证据质量等级普遍较低.结论:本研究为中医药临床治疗IBS提供一定参考,但基于GRADE证据质量等级,建议证据使用者根据临床实践的具体情况进行循证决策.此外,中医药临床研究需根据自身特点,选择合适的研究设计方法,进一步开展高质量的临床研究,为评价中医药治疗IBS的临床疗效提供高质量的证据.展开更多
Objective To compare the difference in the therapeutic effects on diarrhea- type irritable bowel syndrome (D-IBS) between acupuncture based on soothing the liver and strengthening the spleen and western medicine. Me...Objective To compare the difference in the therapeutic effects on diarrhea- type irritable bowel syndrome (D-IBS) between acupuncture based on soothing the liver and strengthening the spleen and western medicine. Methods Seventy cases were randomized into an acupuncture group and a western medicine group, 35 cases in each one. In the acupuncture group, the conventional acupuncture was applied at Tianshu {天枢 ST 25), Zusanli (足三里 ST 36), Shangjuxu {上巨虚 ST 37), Sanyinjiao (三阴交 SP 6), Taichong (太冲 LR 3) and so on. Electric stimulation was supplemented at bilateral ST 25. The treatment was given once a day, 3-4 treatments in a week. In the western medicine group, pinaverium bromide (dicetel) was prescribed for oral administration, 50 mg each time, three times a day. Four weeks made one session in the two groups. Separately, before treatment and after 1 session treatment, the integral of clinical symptom and the score in the scale of the quality of life measure for irritable bowel syndrome (IBS-Q OL) were observed for the patients in the two groups. The efficacy and recurrence rate were assessed in the two groups. Results The symptom integral and IBS-QOL score in the two groups were improved significantly after treatment Call P〈0.01), and the improvements in the acupuncture group were superior to that in the western medicine group (P〈0.01). The effective rate was 94.3% {33/35) in the acupuncture group, which was superior to 77.1% (27/35) in the western medicine group (P〈0.01). In 3 months, the recurrence rate was 36.4% (12/33) in the acupuncture group, which was lower apparently than 72.0% (18/25) in the western medicine group (P〈O.01). Conclusion Acupuncture therapy based on soothing the liver and strengthening the spleen achieves the superior efficacy on D-IBS as compared with western medication, pinaverium bromide. This therapy improves apparently the quality of life of the patients and is lower in recurrence rate.展开更多
文摘目的:对中医药治疗肠易激综合征(irritable bowel syndrome,IBS)的系统评价/Meta分析进行再评价研究.方法:计算机检索Cochrane Library、PubMed、AMED、E M b a s e、C B M、C N K I、V I P和WanFang Data,收集中医药治疗IBS的系统评价/Meta分析文章,检索时限均从建库至2013-11.由2位研究者按照纳入标准独立筛选文献、提取资料后,采用AMSTAR评价纳入研究质量,同时采用GRADE系统对主要研究结果进行证据质量分级.结果:共纳入14个相关系统评价/Meta分析,10篇研究评价了中草药疗效,4篇研究评价了针灸疗法,AMSTAR评分在2-10分之间,再评价主要结果显示,中医药治疗IBS较常规西药具有一定优势,但证据质量等级普遍较低.结论:本研究为中医药临床治疗IBS提供一定参考,但基于GRADE证据质量等级,建议证据使用者根据临床实践的具体情况进行循证决策.此外,中医药临床研究需根据自身特点,选择合适的研究设计方法,进一步开展高质量的临床研究,为评价中医药治疗IBS的临床疗效提供高质量的证据.
基金Supported by Leading Talent Project of Jiangsu Administraion of TCM: LJ 200905
文摘Objective To compare the difference in the therapeutic effects on diarrhea- type irritable bowel syndrome (D-IBS) between acupuncture based on soothing the liver and strengthening the spleen and western medicine. Methods Seventy cases were randomized into an acupuncture group and a western medicine group, 35 cases in each one. In the acupuncture group, the conventional acupuncture was applied at Tianshu {天枢 ST 25), Zusanli (足三里 ST 36), Shangjuxu {上巨虚 ST 37), Sanyinjiao (三阴交 SP 6), Taichong (太冲 LR 3) and so on. Electric stimulation was supplemented at bilateral ST 25. The treatment was given once a day, 3-4 treatments in a week. In the western medicine group, pinaverium bromide (dicetel) was prescribed for oral administration, 50 mg each time, three times a day. Four weeks made one session in the two groups. Separately, before treatment and after 1 session treatment, the integral of clinical symptom and the score in the scale of the quality of life measure for irritable bowel syndrome (IBS-Q OL) were observed for the patients in the two groups. The efficacy and recurrence rate were assessed in the two groups. Results The symptom integral and IBS-QOL score in the two groups were improved significantly after treatment Call P〈0.01), and the improvements in the acupuncture group were superior to that in the western medicine group (P〈0.01). The effective rate was 94.3% {33/35) in the acupuncture group, which was superior to 77.1% (27/35) in the western medicine group (P〈0.01). In 3 months, the recurrence rate was 36.4% (12/33) in the acupuncture group, which was lower apparently than 72.0% (18/25) in the western medicine group (P〈O.01). Conclusion Acupuncture therapy based on soothing the liver and strengthening the spleen achieves the superior efficacy on D-IBS as compared with western medication, pinaverium bromide. This therapy improves apparently the quality of life of the patients and is lower in recurrence rate.