A meta-analysis of the clinical efficacy and safety of combining Buzhong Yiqi Decoction with acupoint application in treating functional constipation
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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。Abstract: 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 5.4 software for meta-analysis and outcome index classification.Results A total of 44 articles were searched, and 9 were ultimately included, covering 752 patients. 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 efficacy of functional constipation, improve defecation related symptoms and gastrointestinal function with good safety.
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Key words:
- functional constipation /
- Buzhong Yiqi Decoction /
- acupoint application /
- meta-analysis
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表 1 纳入文献的基本特征
文献 时间 样本量/例 干预措施 评价时间/d 结局指标 试验组/对照组 试验组 对照组 杨咏梅等[3] 2014 40/40 补中益气汤+穴位贴敷 麻仁丸 10 ①②③④⑤⑥ 马维军[4] 2017 53/53 补中益气汤+穴位贴敷 麻仁丸 10 ①②③④⑤⑥⑪ 尹霞[5] 2018 50/50 补中益气汤+穴位贴敷 乳果糖 14 ①⑦⑨ 毛刚等[6] 2020 52/52 补中益气汤+穴位贴敷 聚乙二醇4000散 28 ①④⑤⑥⑧⑩ 叶晓声等[7] 2020 25/25 补中益气汤+穴位贴敷+乳果糖 乳果糖 14 ①②⑦ 陈晓光[8] 2021 41/41 补中益气汤+穴位贴敷 聚乙二醇4000散 56 ④⑤⑧ 魏林少强[9] 2021 37/37 补中益气汤+穴位贴敷 穴位贴敷+乳果糖 14 ①②③④⑤⑥⑦ 许建慧[10] 2021 48/48 补中益气汤+穴位贴敷 穴位贴敷 15 ①② 陈娇娇等[11] 2022 30/30 补中益气汤+穴位贴敷 补中益气汤 10 ①②⑪ 注：①总有效率；②治愈率；③排便间隔时间评分；④排便难度评分；⑤排便速度评分；⑥大便性状评分；⑦胃肠功能指标水平；⑧肛管直肠动力学指标水平；⑨中医症状积分；⑩肠道菌群参数；⑪治疗满意度。 
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