Department of Neurosurgery, The First Affiliated Hospital of Hainan Medical University, Haikou, China.
Department Traditional Chinese Medicine, The First Affiliated Hospital of Hainan Medical University, Haikou, China.
Ann Palliat Med. 2021 Nov;10(11):11808-11820. doi: 10.21037/apm-21-2915.
Gastrointestinal dysfunction is one of the complications after stroke. If it is not treated in time, it will affect the rehabilitation process after stroke and reduce the quality of life of patients. In this study, we conducted a systematic review and meta-analysis of the reports on the treatment of gastrointestinal dysfunction after stroke with traditional Chinese medicine (TCM) in recent years to provide evidence for clinical diagnosis and treatment.
The clinical randomized controlled trials (RCTs) published in Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Medline, and Web of Science databases from January 2010 to August 2021 were searched. After screening the qualified literatures, literature quality evaluation was performed. The software Stata 16.0 was used to analyze and compare the outcome indicators of TCM and conventional western medicine treatment, and the utility of TCM in the treatment of gastrointestinal disorders after stroke was comprehensively evaluated.
A total of 16 studies were finally selected including a total of 1,589. Meta-analysis showed that TCM treatment of gastrointestinal disorders after stroke was more effective than conventional western medicine treatment [odds ratio (OR) =3.94; 95% confidence interval (CI): 2.63 to 5.89; P=0.000]. It was also shown that TCM can reduce the recovery time of bowel sounds and is superior to conventional western medicine [standard mean difference (SMD) =-1.92; 95% CI: -2.51 to -1.34; P=0.000]; reduce defecation and flatulence recovery time (SMD =-2.51; 95% CI: -3.41 to -1.61; P=0.000); increase gastrin level (SMD =0.80; 95% CI: 0.35 to 1.25; P=0.001); increase motilin level (SMD =2.27; 95% CI: 1.55 to 3.00; P=0.000); increase serum albumin level (SMD =0.72; 95% CI: 0.54 to 0.90; P=0.000); increase transferrin levels (SMD =1.11; 95% CI: 0.86 to 1.36; P=0.000); and it can increase serum prealbumin levels (SMD =1.50; 95% CI: 0.78 to 2.22; P=0.000).
The use of TCM in the treatment of gastrointestinal dysfunction after stroke can effectively reduce symptoms, shorten the recovery time of bowel sounds, the first defecation and flatulence time, promote gastric motility and gastrointestinal hormone secretion, and improve the nutritional status of patients.
胃肠功能障碍是中风后的并发症之一。如果不及时治疗，会影响中风后的康复进程，降低患者的生活质量。本研究对近年来中医药治疗中风后胃肠功能障碍的临床随机对照试验（RCT）进行系统评价和 Meta 分析，为临床诊治提供证据。
检索 2010 年 1 月至 2021 年 8 月中国生物医学文献数据库（CBM）、中国知网（CNKI）、Medline 和 Web of Science 数据库中关于中医药治疗中风后胃肠功能障碍的临床随机对照试验，筛选合格文献后进行文献质量评价。采用 Stata 16.0 软件对 TCM 和常规西药治疗的结局指标进行分析比较，综合评价 TCM 在中风后胃肠功能障碍治疗中的作用。
最终纳入 16 项研究，共 1589 例患者。Meta 分析显示，中医药治疗中风后胃肠功能障碍的疗效优于常规西药[比值比（OR）=3.94；95%置信区间（CI）：2.63 至 5.89；P=0.000]。同时，中医药还能缩短肠鸣音恢复时间，优于常规西药[标准均数差（SMD）=-1.92；95%CI：-2.51 至-1.34；P=0.000]，缩短排便和排气恢复时间（SMD=-2.51；95%CI：-3.41 至-1.61；P=0.000），提高胃泌素水平（SMD=0.80；95%CI：0.35 至 1.25；P=0.001），提高胃动素水平（SMD=2.27；95%CI：1.55 至 3.00；P=0.000），提高血清白蛋白水平（SMD=0.72；95%CI：0.54 至 0.90；P=0.000），提高转铁蛋白水平（SMD=1.11；95%CI：0.86 至 1.36；P=0.000），提高血清前白蛋白水平（SMD=1.50；95%CI：0.78 至 2.22；P=0.000）。
中医药治疗中风后胃肠功能障碍能有效缓解症状，缩短肠鸣音恢复时间、首次排便和排气时间，促进胃动力和胃肠激素分泌，改善患者营养状况。
