Faculty of Health, Medicine, Nursing and Behavioural Sciences, School of Nursing, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia.
J Altern Complement Med. 2009 Dec;15(12):1335-46. doi: 10.1089/acm.2008.0373.
The aim of this systematic review was to critically appraise published clinical trials designed to assess the effect of Traditional Chinese Medicine (TCM) on the management of constipation.
Databases searched included both English and non-English articles published in the Cochrane library, MEDLINE, CINAHL, AMED, EMBASE, China National Knowledge Infrastructure (CNKI), and the Chinese Electronic Periodical Services (CEPS). Studies reviewed included randomized controlled trials and controlled clinical trials. Methodological quality was assessed using the modified Jadad scale.
One hundred and thirty-seven (137) studies met the inclusion criteria, of which 21 were high-quality trials (n = 2449). Eighteen (18) were Chinese herbal medicine (CHM) and 3 were acupuncture trials. The primary outcome measure was total effective rate. CHM was more effective than conventional medicines in eight trials. Of the 10 remaining CHM trials, 9 compared the study CHM with another CHM and the results were significant in 4 trials. The effective rate was significantly higher in the intervention group than in the placebo group in the last CHM study. One (1) of the three acupuncture trials compared acupuncture with a conventional medicine, one trial with Sennae folium, and one trial with deeper acupuncture on Tianshu (ST 25). The therapeutic effect in the treatment group was more effective than that in the control group in all three studies.
TCM interventions appear to be useful to manage constipation. Significant positive results were found in 15 high-quality studies. However, only 21 of the 137 publications identified attained high Jadad scores. There was heterogeneity in diagnostic procedures and interventions among the studies. Outcome indicators were also different. Hence, the results should be interpreted cautiously.
本系统评价旨在批判性评估旨在评估中医药（TCM）对便秘管理影响的临床试验。
搜索的数据库包括 Cochrane 图书馆、MEDLINE、CINAHL、AMED、EMBASE、中国知网（CNKI）和中国电子期刊服务（CEPS）中的英文和非英文文章。综述包括随机对照试验和对照临床试验。使用改良 Jadad 量表评估方法学质量。
符合纳入标准的研究有 137 项，其中 21 项为高质量试验（n=2449）。18 项为中草药（CHM）试验，3 项为针刺试验。主要结局指标为总有效率。在 8 项试验中，CHM 比常规药物更有效。在其余 10 项 CHM 试验中，9 项将研究 CHM 与另一种 CHM 进行比较，其中 4 项试验结果有统计学意义。在最后一项 CHM 研究中，干预组的有效率明显高于安慰剂组。3 项针刺试验中，1 项将针刺与常规药物进行比较，1 项与番泻叶比较，1 项与天枢（ST 25）进行更深的针刺比较。在所有 3 项研究中，治疗组的治疗效果均优于对照组。
TCM 干预措施似乎对治疗便秘有用。15 项高质量研究中发现了显著的阳性结果。然而，在 137 篇已确定的出版物中，仅有 21 篇获得了较高的 Jadad 评分。研究之间的诊断程序和干预措施存在异质性。结局指标也不同。因此，结果应谨慎解释。
