| Objective:Using meta-analysis to evaluate the effectiveness and safety of oral preparations of traditional Chinese medicine in the treatment of adult functional constipationMethod:Use "Chinese medicine","Chinese herbal medicine","Chinese traditional medicine","Chinese and Western medicine","herb","TCM" and"functional constipation"as keywords to search CNKI,Wanfang,Weipu database,Pubmed,Embase,The Cochrane Library database.The search time is from self-built database to February 1,2021.We strictly follow the inclusion and exclusion criteria.The intervention measures included in the experimental group are oral Chinese medicine decoctions,and the intervention measures in the control group are purely taking IA-grade drugs polyethylene glycol or prucalopride,and the research object is adult functional constipation.The above operations were performed by two physicians in strict accordance with the inclusion and exclusion criteria,and independently carried out the literature screening work,and used the NoteExpress software to de-duplicate the included literature,and then screened out those that did not meet the inclusion criteria or meet the exclusion criteria by reading the title,,and full text.If there is a disagreement,it will be discussed by both parties or agreed by a doctor with a higher seniority,and the included literature will be finally determined.The included literature was evaluated according to the Risk of Bias Tool recommended by the Cochrane Collaboration.Use RevMan 5.4 software to conduct荟萃 analysis and bias risk assessment.According to different data types,different effect indexes were selected,such as OR(odds ratio),MD(mean difference),SMD(standard mean difference).Judge whether there is heterogeneity by calculating the Q value test statistic P value,and by calculating the I2 value statistic to see the degree of heterogeneity,choose different effect models according to the I2 results.P<0.05 was considered statistically different.Result:A total of 27 literatures were included in this study,all in Chinese,and a total of 2,021 patients were included.The intervention measure of the control group was oral polyethylene glycol electrolyte powder in a total of 25 literatures:23 literatures in the experimental group were oral Chinese medicine preparation alone,and 2 literatures in the experimental group were oral Chinese medicine preparation combined with polyethylene glycol.There were 2 literatures in which the intervention measure of the control group was prucalride,of which the intervention measure of the experimental group was Chinese medicine combined with prucalride succinate,and the intervention measure of the experimental group was Chinese medicine alone.Due to the limitation of the number of included literatures,only 23 literatures with traditional Chinese medicine preparation as the intervention measure in the experimental group and polyethylene glycol as the intervention measure in the control group were meta-analyzed,.Three indexes were evaluated in this 荟萃-analysis:effective rate,recurrence rate and safety.The results are as follows:1 All the 23 literatures evaluated the clinical effective rate,including 1753 patients.The meta-analysis results showed that OR=3.06,95%CI[2.33,4.01],P<0.05,the difference between the experimental group and the control group was statistically significant,and the efficacy of the experimental group was better than the control group.2 As for the recurrence rate,8 literatures evaluated the recurrence rate,one of which not only evaluated the recurrence rate at 2 weeks after the end of treatment,but also described the recurrence rate at 4 weeks after the end of treatment.Therefore,655 patients were included and the 荟萃-analysis results showed that OR=0.37,95%CI[0.25,0.53],P<0.05.The difference between the experimental group and the control group was statistically significant,that is,the recurrence rate of functional constipation treated by oral Chinese medicine preparation alone was less than that of polyethylene glycol.3 In terms of safety,19 literatures evaluated safety indicators,including 1415 patients.The results showed as follows:OR=0.39,950%CI[0.13,1.12],and the total OR value P=0.08>0.05,so there was no statistical difference between the safety of two groups.That is,there was no statistical difference between the safety of Chinese medicine for functional constipation and polyethyl glycol.4 In addition,there are 19 papers evaluated the constipation(defecation frequency,defecate difficulty,time needed for defecation,defecation time interval and feces properties)and(or)of traditional Chinese medicine syndrome,but because of a single symptom of quantitative standard and integral standard is not the same,so it can’t be evaluated by meta analysis,only do descriptive analysis,descriptive analysis shows:compared with polyethylene glycol(peg)oral Chinese medicine can be faster and more effectively relieve single symptom.Conclusion:1 In the treatment of adult functional constipation,oral traditional Chinese medicine preparation has better clinical efficacy and lower long-term recurrence rate than polyethylene glycol.Both of them are safe.2 The comparison between traditional Chinese medicine and prucalride needs to be verified.3 The comparison between integrated Chinese and western medicine and western medicine also needs to be verified. |
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