中药治疗慢性功能性便秘效果的系统评价

目的系统评价中药治疗慢性功能性便秘的疗效及安全性。方法计算机检索CNKI（1989～2009.11）、CBM（1989～2009.11）、VIP（1989～2009.11）、CochraneLibrary（2009年第4期）、PubMed（1966～2009.11）和EMbase（1986～2009.11）等,纳入中药与空白、安慰剂或西药对照治疗慢性功能性便秘的随机和半随机对照临床试验,由两名研究者按照CochraneHandbook5.0.2标准独立评价文献质量、提取数据并交叉核对,使用RevMan5.0软件进行Meta分析。结果共纳入21个研究,合计2-602例患者。Meta分析结果显示：中药能改善慢性功能性便秘患者的症状及结肠传输功能,其疗效优于促胃肠动力药有效率RR=1.18,95%CI（1.12,1.25）;痊愈率RR=1.59,95%CI（1.35,1.88）]及泻剂有效率RR=1.18,95%CI（1.10,1.27）;痊愈率RR=1.65,95%CI（1.29,2.10）];中药联合促胃肠动力药疗效优于促胃肠动力药有效率RR=1.21,95%CI（1.09,1.34）;痊愈率RR=1.41,95%CI（1.11,1.79）]。结论部分中药治疗慢性功能性便秘安全有效,但因尚缺乏高质量的研究,目前还不能得到较为可靠的结论。

Efficacy of Chinese Herbal Medicines in Treating Chronic Functional Constipation:A Systematic Review

Objective To assess the effcacy and safety of Chinese herbal medicines for chronic functional consti-pation. Methods We searched CNKI （1989 to November, 2009）, CBM （1989 to November, 2009）, VIP （1989 to No-vember, 2009）, Cochrane Library （Issue 4, 2009）, PubMed （1966 to November, 2009） and EMbase （1986 to November, 2009）. All randomized and quasi-randomized clinical trials of treating chronic functional constipation with Chinese herbal medicines versus untreated, placebo or western drug groups were included. Data were extracted independently by two reviewers. The methodological quality of trials was evaluated with Cochrane Handbook 5.0.2 criteria. Meta-analyses were conducted by the RevMan 5.0 software. Results Twenty-one trials involving 2-602 patients were included. The Meta-analysis results showed that： Chinese herbal medicines improved both syndromes and colonic transit function of recipients; moreover, it is superior to both gastrointestinal prokinetic agent in effective rate （RR=1.18, 95%CI 1.12 to 1.25）, healing rate （RR=1.59, 95%CI 1.35 to 1.88）, and cathartic in effective rate （RR=1.18, 95%CI 1.10 to 1.27）, healing rate （RR=1.16, 95%CI 1.29 to 2.10）. Integration of Chinese herbal medicines and gastrointestinal prokinetic agent is superior to gastrointestinal prokinetic agent in effective rate （RR=1.21 95%CI 1.09 to 1.34） and healing rate （RR=1.41, 95%CI 1.11 to 1.79）. Conclusion Some Chinese herbal medicines may be effective and safe in treating chronic functional constipa-tion, which can not be strongly proved at present for lack of studies with high quality.