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瑜伽治疗肠易激综合征:随机对照试验的系统评价与荟萃分析

Yoga for Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

作者信息

Saab Omar, Al-Obaidi Hasan, Algodi Marwah, Algodi Asma, Rashid Yasir, Al-Sagban Alhareth, Albayyaa Mohanad, Merza Nooraldin, Alzubaidy Layth, Cash Brooks

机构信息

University of Texas Health Sciences Center at Houston; Department of Medicine, Houston, TX.

Jamaica Hospital Medical Center; Department of Medicine, Jamaica, NY.

出版信息

Am J Gastroenterol. 2025 May 13. doi: 10.14309/ajg.0000000000003524.

Abstract

INTRODUCTION

Irritable bowel syndrome (IBS) affects between 10% and 20% of the global population. The therapeutic effect of yoga on IBS symptoms has been investigated by several randomized controlled trials (RCTs) with inconsistent findings. We conducted this review to synthesize the current evidence on yoga's effect on IBS symptoms.

METHODS

A systematic review and meta-analysis were performed through systematically searching PubMed, EMBASE, WOS, SCOPUS, and Cochrane through October 2024. Continuous variables were pooled using the standardized mean difference (SMD), with confidence intervals (CIs) using Stata MP version 17. We assessed heterogeneity using the χ 2 test and I2 statistics. PROSPERO ID: CRD42024611633.

RESULTS

Eleven RCTs with 535 patients were included. Seven RCTs included adults, 3 included pediatric or adolescent patients, and another included adolescents and young adults. The yoga intervention type varied among the included trials, with the program duration ranging from 6 weeks to 8 months and the session duration ranging from 40 to 90 minutes. There was no difference between yoga and control groups in alleviating the severity of gastrointestinal symptoms (SMD -0.66, with 95% CI -1.51 to 0.18, P = 0.12), anxiety (SMD -0.39, with 95% CI -0.85 to 0.06, P = 0.09), and depression (SMD -0.46, with 95% CI -1.15 to 0.22, P = 0.19) or improving quality of life (SMD 0.53, with 95% CI -0.38 to 1.44, P = 0.25).

DISCUSSION

With uncertain evidence, yoga did not reduce the gastrointestinal severity of symptoms, anxiety, and depression or improve quality of life in patients with IBS. In light of the considerable methodological heterogeneity and the high risk of bias within the included RCTs, Yoga cannot be recommended as a treatment for IBS before conducting further large-scale RCTs to fill the current evidence gaps.

摘要

引言

肠易激综合征(IBS)影响着全球10%至20%的人口。几项随机对照试验(RCT)对瑜伽治疗IBS症状的疗效进行了研究,但结果并不一致。我们进行了这项综述,以综合当前关于瑜伽对IBS症状影响的证据。

方法

通过系统检索截至2024年10月的PubMed、EMBASE、WOS、SCOPUS和Cochrane数据库,进行系统综述和荟萃分析。连续变量采用标准化均值差(SMD)进行合并,并使用Stata MP 17版本计算置信区间(CI)。我们使用χ²检验和I²统计量评估异质性。PROSPERO注册号:CRD42024611633。

结果

纳入了11项RCT,共535例患者。7项RCT纳入了成年人,3项纳入了儿童或青少年患者,另一项纳入了青少年和青年成年人。纳入试验中的瑜伽干预类型各不相同,项目持续时间从6周到8个月不等,每次课程时长从40到90分钟不等。在缓解胃肠道症状严重程度(SMD -0.66,95%CI -1.51至0.18,P = 0.12)、焦虑(SMD -0.39,95%CI -0.85至0.06,P = 0.09)和抑郁(SMD -0.46,95%CI -1.15至0.22,P = 0.19)或改善生活质量(SMD 0.53,95%CI -0.38至1.44,P = 0.25)方面,瑜伽组与对照组之间没有差异。

讨论

由于证据不确定,瑜伽并不能降低IBS患者的胃肠道症状严重程度、焦虑和抑郁程度,也不能改善生活质量。鉴于纳入的RCT存在相当大的方法学异质性和较高的偏倚风险,在进行进一步的大规模RCT以填补当前证据空白之前,不建议将瑜伽作为IBS的治疗方法。

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