Department of Nephrology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of Nursing, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
PLoS One. 2023 Oct 5;18(10):e0291968. doi: 10.1371/journal.pone.0291968. eCollection 2023.
The purpose of this study was to evaluate the curative effect of external therapies of traditional Chinese medicine on constipation in patients with chronic renal failure and to provide scientific theoretical basis for clinical practice.
We searched the English database of PubMed, EMBASE, the Cochrane Library and the Web of Science and Chinese database of CNKI, Wan fang database, VIP Database and China Biomedical Literature Database up to December 2022. Randomized controlled trials (RCTs) involving constipation in patients with CRF that compared external therapies of traditional Chinese medicine and routine treatment to routine treatment were eligible for the analysis. A meta-analysis of the outcome indicators including total efficiency, weekly defecation times, defecation time, defecation difficulty score, patient-assessment of constipation quality of life and adverse events of treatment were performed. The analysis was performed by using Review Manager version 5.3.
A total of 23 studies were included, with 1764 patients. Meta-analysis results showed that compared with the control group, the test group could significantly increase weekly defecation times(MD = 0.94, 95%CI(0.70, 1.18), Z = 7.74, P < 0.00001), reduce defecation time(MD = -2.92, 95%CI(-3.69, -2.16), Z = 7.49, P < 0.00001), reduce defecation difficulty score(MD = -1.92, 95%CI(-2.45, -1.39), Z = 7.11, P < 0.00001), improve the quality of life in patients with constipation(MD = -7.57, 95%CI(-10.23, -4.91), Z = 5.58, P < 0.00001) and obtain a higher total effective rate of treatment(OR = 4.53, 95%CI(3.27, 6.29), Z = 9.07, P < 0.00001). In terms of safety, there was no statistical significance in the incidence of adverse events between two groups(OR = 0.35, 95%CI(0.04, 2.95), Z = 0.96, P = 0.34).
The combination of external therapies of traditional Chinese medicine and routine treatment could achieve an excellent curative effect, and there was no specific adverse event. However because of the limited level of current evidence, more high-quality trials are needed in the future.5.
本研究旨在评估中医外治法治疗慢性肾衰竭患者便秘的疗效，为临床实践提供科学的理论依据。
我们检索了 PubMed、EMBASE、Cochrane 图书馆和 Web of Science 英文数据库以及中国知网、万方数据库、维普数据库和中国生物医学文献数据库，检索时限均为建库至 2022 年 12 月。纳入比较中医外治法与常规治疗对比常规治疗治疗慢性肾衰竭患者便秘的随机对照试验（RCT）。采用 Review Manager 5.3 软件进行总有效率、每周排便次数、排便时间、排便困难评分、患者便秘生活质量评分和治疗不良反应发生率等结局指标的 meta 分析。
共纳入 23 项研究，1764 例患者。Meta 分析结果显示，与对照组相比，试验组可显著增加每周排便次数[MD=0.94，95%CI（0.70，1.18）]，Z=7.74，P<0.00001），缩短排便时间[MD=-2.92，95%CI（-3.69，-2.16）]，Z=7.49，P<0.00001），降低排便困难评分[MD=-1.92，95%CI（-2.45，-1.39）]，Z=7.11，P<0.00001），改善患者便秘生活质量[MD=-7.57，95%CI（-10.23，-4.91）]，Z=5.58，P<0.00001），且治疗总有效率更高[OR=4.53，95%CI（3.27，6.29）]，Z=9.07，P<0.00001）。安全性方面，两组不良反应发生率无统计学差异[OR=0.35，95%CI（0.04，2.95）]，Z=0.96，P=0.34）。
中医外治法联合常规治疗可取得较好的疗效，且无特殊不良反应。但由于目前证据水平有限，未来还需要更多高质量的试验。
