Memorial Sloan Kettering Cancer Center, Bendheim Integrative Medicine Center, 1429 First Avenue, New York, NY, 10021, United States.
Memorial Sloan Kettering Cancer Center, Bendheim Integrative Medicine Center, 1429 First Avenue, New York, NY, 10021, United States; Department of Integration of Chinese and Western Medicine, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education, Beijing), Peking University Cancer Hospital & Institute, Beijing 100142, China.
Phytomedicine. 2021 Feb;82:153459. doi: 10.1016/j.phymed.2021.153459. Epub 2021 Jan 5.
There is growing interest in using herbal supplements to treat constipation; however, little evidence exists for their use.
This study evaluates the efficacy and safety of herbal formula MaZiRenWan (Hemp Seed Pill, HSP) in patients with functional or non-functional constipation.
Systematic review and meta-analysis METHODS: PubMed, CENTRAL, Embase, CNKI, and Wanfang were searched through April 20, 2020 for randomized trials of HSP versus placebo or medications for all types of constipation. The primary outcomes were complete response rate, complete spontaneous bowel movement (CSBM), patient-reported satisfactory treatment rate (prSTR), and adverse events (AEs). Clinical data were analyzed using a random-effects model, and the quality of evidence was evaluated with the GRADE system.
This review includes 1681 constipation patients from 17 moderate-to-high risk of bias trials that were conducted in east Asia. Two high-quality trials showed that HSP compared with placebo significantly increased weekly CSBM (mean difference, 0.95; 95% CI: 0.56, 1.35) and had a higher complete response rate (risk ratio [RR], 1.43; 95% CI: 1.20, 1.71) in patients with functional constipation. Low-quality evidence showed significant improvement in prSTR in HSP compared with conventional medications (RR, 1.79; 95% CI: 1.42, 2.25). Additionally, HSP use did not increase AEs compared with no HSP (p = 0.99).
This study found that HSP was effective among Asian patients with functional constipation. Rigorous trials need to be conducted in clinical populations outside of east Asia and in those with non-functional constipation to increase the generalizability of the evidence.
人们对使用草药补充剂治疗便秘越来越感兴趣；然而，关于其使用的证据很少。
本研究评估了麻仁丸（Hemp Seed Pill，HSP）治疗功能性或非功能性便秘患者的疗效和安全性。
系统评价和荟萃分析
检索 PubMed、CENTRAL、Embase、CNKI 和万方数据库，截至 2020 年 4 月 20 日，收集 HSP 与安慰剂或药物治疗各种类型便秘的随机对照试验。主要结局指标为完全缓解率、完全自发性排便（CSBM）、患者报告的治疗满意度（prSTR）和不良反应（AEs）。采用随机效应模型分析临床数据，并采用 GRADE 系统评估证据质量。
本综述纳入了来自东亚 17 项中高偏倚风险试验的 1681 例便秘患者。两项高质量试验表明，与安慰剂相比，HSP 显著增加了每周 CSBM（平均差异，0.95；95%CI：0.56，1.35），并显著提高了功能性便秘患者的完全缓解率（RR，1.43；95%CI：1.20，1.71）。低质量证据表明，与传统药物相比，HSP 显著提高了 prSTR（RR，1.79；95%CI：1.42，2.25）。此外，与无 HSP 相比，HSP 组不良反应发生率无差异（p = 0.99）。
本研究发现 HSP 对亚洲功能性便秘患者有效。需要在东亚以外的临床人群中以及非功能性便秘患者中进行严格的试验，以提高证据的普遍性。
