| ObjectiveStudy ?: The purpose of this study was to evaluate the clinical efficacy of Cheng-Qi series decoction therapy in the treatment of intestinal obstruction through systematic review and Meta analysis.Study ?: Through retrospective studies,the comprehensive evaluation of the short-term and long-term curative effects of XingQiTongFu decoction in the treatment of intestinal obstruction was conducted.MethodsStudy ?: Through searching English databases such as Pubmed,The Cochrane library,and EMbase,and Chinese databases such as CNKI,VIP,and WanFang Data,the search time limit is based on a database database until December 2017.The content of the search was a RCT study using Cheng-Qi serise decoction agent to treat intestinal obstruction.Through the screening,the required research data were extracted,including baseline information,intervention measures,research methodological quality,outcome indicators,and outcome data for patients with intestinal obstruction.The methodological quality of the included studies was then assessed according to the Covariance Risk Assessment Tool of the Cochrane Systematic Reviewer's Manual,Version 5.1.0.Meta analysis was performed using Stata13 software and RevMan 5.3 software provided by Cochrane Collaboration.Study 2: A retrospective survey of patients with intestinal obstruction who were admitted to the General Surgery Department of Affiliated Hospital of Shandong University of Traditional Chinese Medicine from July 2014 to October 2017.The patients were diagnosed as having intestinal obstruction by preliminary deletion from the electronic medical record system and reviewed again.In complete cases,patients diagnosed with "intestinal obstruction" and who were first diagnosed were included in this study.1 The general information,physical and chemical examination results,treatment history,and outcomes of all patients during the visit were collated and summarized,statistical tables were set up,data analysis was performed,and the same information was collected and processed separately for patients undergoing XingQiTongFu decoction.And data analysis.2 Each hospitalized case is treated as a follow-up unit(except for hospitalized outcomes that are deaths),at intervals of 4 weeks,1 month,3 months,6 months,1 year,2 years,and 3 years after each treatment discharge.Follow-up time(part of the patients were followed up at the outpatient visit time),deadline December 31,2017.Record recurrence time,post-relapse treatment,treatment outcomes,and other information.3 According to the obtained hospitalization outcome and follow-up information,the risk factors and risk factors for recurrence were analyzed.According to the use of traditional Chinese medicine,all patients who received XingQiTongFu decoction treatment were treated with enema with Chinese medicine.Risk factors for death and recurrence risk factors were analyzed separately for patients.4 According to whether or not to accept the traditional Chinese medicine treatment and route of administration are divided into not using traditional Chinese medicine group,Chinese medicine enema group,Chinese medicine oral / gastric tube injection group,Chinese medicine enema + Chinese medicine oral / gastric tube injection group,for patients with intestinal obstruction The short-term efficacy and recurrence of the group were compared.ResultsStudy ?: Compared with conventional western medicine treatment,Cheng-Qi series decoction prescription combined with western medicine routine treatment of intestinal obstruction is more effective than conventional western medicine treatment,and can significantly improve intestinal obstruction symptoms and shorten treatment time.The difference is statistically significant: total effective rate [ OR = 5.285,95% CI(4.027,6.937),P = 0.000];spontaneous exhaust time [SMD =-2.022,95% CI(-2.695,-1.550),P = 0.000];time of spontaneous bowel movement;[SMD =-2.329,95% CI(-3.030,-1.628),P=0.000];bowel sound recovery time [SMD=-2.438,95%CI(-3.218,-1.659),P=0.000];abdominal pain relief Time [SMD =-1.91,95% CI(-2.521,-1.301),P = 0.000];Nausea and Vomit Remission Time [SMD =-2.016,95% CI(-2.362,-1.671),P = 0.000];Fluid disappearing time [SMD =-3.608,95% CI(-6.476,-0.740),P = 0.014];Total hospital stay [SMD =-1.420,95% CI(-1.715,-1.125),P = 0.000].Study ?: 138 patients were followed-up for a total of 180 follow-up visits,of which 159 were successfully followed up and 21 were detached.Of the 159 successful follow-up visits,147 were non-surgical and 12 were surgical.Treatment of cases.There were a total of 50(31.45%)recurrences(47 non-surgical patients relapsed and 3 surgically treated);76(47.80%)patients had no recurrence,and 33(20.75%)had no death(recurrence or cause of death).).Among the 50 cases,47 cases were hospitalized,except for 1 case of follow-up at the time of hospitalization treatment,41 cases of non-surgical treatment,38 cases of cured or improved discharge(1 case was improved after discharge and died,the cause of death is unknown)3 cases died;5 cases were treated with surgery,cured or improved and discharged without recurrence after discharge.Three patients who were not hospitalized had symptoms disappeared at follow-up and did not relapse.Follow-up duration was 4 days to 41 months(mean [SD] 16.06 [12.09] months,median 13.97 months).Except one case whose recurrence time was not clear,the remaining 49 cases had recurrence time from 4 days to 21 months(mean [SD] 4.38 [4.73] months,median 3 months).Conservative treatment was performed in 44 patients and no recurrence occurred at the last follow-up.Five patients who were admitted to hospital after surgery for recurrence were all effective.No recurrence occurred after discharge.The five patients were all patients who had relapsed for the first time and had not received surgical treatment.Surgical methods and specific treatments are unknown.2 The independent risk factors for death in all 195 cases were: nutritional risk score,malignancy and Metastasis;128 independent risk factors for the death of 128 patients who received XingQiTongFu decoction were not found;109 patients who received gas phlegm and Chinese medicine enema treatment died.The independent risk factors were: malignant tumors and Metastases.3 The independent risk factors for recurrence of all 126 follow-up cases were: body weight;the independent risk factors for recurrence of 95 patients receiving XingQiTongFu decoction were: body weight;independent risk factors for recurrence of 82 cases treated with XingQiTongFu decoction.Not found.4 Short-term efficacy: There was a difference in the total effective rate between traditional Chinese medicine enema+Chinese medicine oral/stomach tube injection group and the non-use Chinese medicine group(P=0.003),and there was no significant difference among other groups(P>0.05)Recurrence: There was no significant difference in the recurrence rate between groups(P>0.05).ConclusionStudy ?: Cheng-Qi Series Decoction can effectively treat intestinal obstruction,and its curative effect is better than that of conventional treatment alone.Due to the quantity and quality limitations of the included studies,the above conclusions are subject to further verification by more high-quality controlled studies.Study ?: The independent risk factors for the death of patients with intestinal obstruction are “nutrition risk score” and “malignant tumor Metastasis”;the independent risk factor for recurrence of intestinal obstruction is “weight”,but subject to sample size,there may be undiscovered The independent risk factors need to further expand the sample size in order to obtain more comprehensive and reliable data.2 XingQiTongFu decoction can effectively treat intestinal obstruction,Chinese medicine enema + Chinese medicine oral/stomach tube injection is more effective than non-use Chinese medicine,but there is no significant difference between the methods of administration;no use of traditional Chinese medicine and various routes of administration to XingQiTongFu decoction.There is no significant difference in the recurrence rate of Chinese medicine in treating intestinal obstruction,and its long-term efficacy needs to be further improved by prospective studies and high-quality retrospective studies. |
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