Barnes J, Resch K L, Ernst E
Department of Complementary Medicine, Postgraduate Medical School, University of Exeter, United Kingdom.
J Clin Gastroenterol. 1997 Dec;25(4):628-33. doi: 10.1097/00004836-199712000-00016.
Homeopathic remedies are advocated for the treatment of postoperative ileus, yet data from clinical trials are inconclusive. We therefore performed meta-analyses of existing clinical trials to determine whether homeopathic treatment has any greater effect than placebo administration on the restoration of intestinal peristalsis in patients after abdominal or gynecologic surgery. We conducted systematic literature searches to identify relevant clinical trials. Meta-analyses were conducted using RevMan software. Separate meta-analyses were conducted for any homeopathic treatment versus placebo; homeopathic remedies of < 12C potency versus placebo; homeopathic remedies of > or = 12C potency versus placebo. A "sensitivity analysis" was performed to test the effect of excluding studies of low methodologic quality. Our endpoint was time to first flatus. Meta-analyses indicated a statistically significant (p < 0.05) weighted mean difference (WMD) in favor of homeopathy (compared with placebo) on the time to first flatus. Meta-analyses of the three studies that compared homeopathic remedies > or = 12C versus placebo showed no significant difference (p > 0.05). Meta-analyses of studies comparing homeopathic remedies < 12C with placebo indicated a statistically significant (p < 0.05) WMD in favor of homeopathy on the time to first flatus. Excluding methodologically weak trials did not substantially change any of the results. There is evidence that homeopathic treatment can reduce the duration of ileus after abdominal or gynecologic surgery. However, several caveats preclude a definitive judgment. These results should form the basis of a randomized controlled trial to resolve the issue.
顺势疗法药物被提倡用于治疗术后肠梗阻，但临床试验数据尚无定论。因此，我们对现有临床试验进行了荟萃分析，以确定顺势疗法治疗在腹部或妇科手术后患者肠道蠕动恢复方面是否比给予安慰剂有更大效果。我们进行了系统的文献检索以识别相关临床试验。使用RevMan软件进行荟萃分析。对任何顺势疗法治疗与安慰剂；效力<12C的顺势疗法药物与安慰剂；效力≥12C的顺势疗法药物与安慰剂分别进行荟萃分析。进行了“敏感性分析”以测试排除低方法学质量研究的影响。我们的终点是首次排气时间。荟萃分析表明，在首次排气时间方面，支持顺势疗法（与安慰剂相比）的加权平均差异（WMD）具有统计学意义（p<0.05）。对三项比较效力≥12C的顺势疗法药物与安慰剂的研究进行的荟萃分析显示无显著差异（p>0.05）。对比较效力<12C的顺势疗法药物与安慰剂的研究进行的荟萃分析表明，在首次排气时间方面，支持顺势疗法的WMD具有统计学意义（p<0.05）。排除方法学上薄弱的试验并未实质性改变任何结果。有证据表明顺势疗法治疗可缩短腹部或妇科手术后肠梗阻的持续时间。然而，一些注意事项妨碍了做出明确判断。这些结果应作为一项随机对照试验的基础，以解决该问题。
