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电针与药物治疗功能性便秘的比较:一项系统评价与Meta分析

Comparison of electroacupuncture and medical treatment for functional constipation: a systematic review and meta-analysis.

作者信息

Zhou Sheng-Li, Zhang Xiu-Lai, Wang Jing-Hua

机构信息

General Medicine, The Second Affiliated Hospital of Zhejiang University College of Medicine, Hangzhou, China.

Department of Anesthesiology, The Second Affiliated Hospital of Zhejiang University College of Medicine, Hangzhou, China.

出版信息

Acupunct Med. 2017 Oct;35(5):324-331. doi: 10.1136/acupmed-2016-011127. Epub 2017 Jun 19.

Abstract

OBJECTIVES

To assess the effectiveness of electroacupuncture (EA) relative to conventional medication in functional constipation (FC).

DESIGN

Systematic review and meta-analysis.

SETTING

To be included, studies needed to: (1) have been randomised controlled trials; (2) have recruited adult patients diagnosed with FC according to the Rome II/III criteria or the American Gastroenterological Association guideline for chronic FC; and (3) have randomised patients to be treated with EA or anti-constipation medication. We searched Medline, the Cochrane Library and Embase databases for articles published up to 30 June 2016.

INTERVENTION

EA or anti-constipation medication.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcome was the change in the number of weekly spontaneous bowel movements. Secondary outcomes were total response rate (or total effective rate), symptom reduction and Cleveland Clinic constipation scores.

RESULTS

The pooled results showed significantly more improvement in the frequency of spontaneous bowel movements in the EA treatment group compared with the medicine-treated group (pooled SMD 0.244, 95% CI 0.065 to 0.424, P=0.008). Deep-needling EA was significantly more effective than treatment with medication at increasing the frequency of spontaneous bowel movements (p=0.019). Significantly greater improvement was also seen for total response rates (p=0.018) and reductions in symptom score (p<0.001) in EA-treated patients.

CONCLUSIONS

EA was more effective than medication at improving spontaneous bowel movements and total response rate, and reducing the symptoms of FC.

摘要

目的

评估电针(EA)相对于传统药物治疗功能性便秘(FC)的有效性。

设计

系统评价和荟萃分析。

设置

纳入的研究需满足:(1)为随机对照试验;(2)招募了根据罗马II/III标准或美国胃肠病协会慢性功能性便秘指南诊断为功能性便秘的成年患者;(3)将患者随机分为接受电针治疗或抗便秘药物治疗组。我们检索了截至2016年6月30日发表在Medline、Cochrane图书馆和Embase数据库上的文章。

干预措施

电针或抗便秘药物。

主要和次要结局指标

主要结局是每周自发排便次数的变化。次要结局是总缓解率(或总有效率)、症状减轻情况和克利夫兰诊所便秘评分。

结果

汇总结果显示,与药物治疗组相比,电针治疗组自发排便频率的改善明显更多(汇总标准化均数差0.244,95%可信区间0.065至0.424,P = 0.008)。深刺电针在增加自发排便频率方面明显比药物治疗更有效(P = 0.019)。电针治疗患者的总缓解率(P = 0.018)和症状评分降低(P < 0.001)也有明显更大的改善。

结论

在改善自发排便、总缓解率以及减轻功能性便秘症状方面,电针比药物更有效。

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