中医外治法治疗消化道肿瘤术后胃肠功能障碍Meta分析

目的:系统评价中医外治法治疗消化道肿瘤术后胃肠功能障碍的临床疗效。方法:计算机检索中国知网、中国生物医学文献数据库、维普资讯、万方数据库、PubMed等数据库,检索时限从建库至2019年12月。检索中医外治法治疗消化道肿瘤术后胃肠功能障碍的临床随机对照试验(randomized controlled trial,RCT),运用Revman 5.3软件进行数据分析及质量评价。结果:最终纳入17个RCT研究,共1388例患者,其中观察组699例,对照组689例。Meta分析结果显示,中医外治法治疗消化道肿瘤术后胃肠功能障碍的有效率OR=5.00,95%CI(2.93,8.53),P<0.00001]高于西医常规治疗,且治疗后观察组在肛门排气恢复时间SMD=-2.33,95%CI(-2.99,-1.66),P<0.00001]、肛门排便恢复时间SMD=-2.18,95%CI(-2.98,-1.37),P<0.00001]、肠鸣音恢复时间SMD=-2.29,95%CI(-2.91,-1.66),P<0.00001]、胃管留置时间SMD=-1.72,95%CI(-2.82,-0.62),P=0.002]、饮食恢复时间SMD=-0.70,95%CI(-1.09,-0.31),P=0.0004]及住院时间SMD=-1.92,95%CI(-2.52,-1.33),P<0.00001]方面均短于对照组,差异具有统计学意义(P<0.05)。结论:中医外治法治疗消化道肿瘤术后胃肠功能障碍的临床有效率高于单纯西医治疗,观察组主要临床症状改善情况均优于对照组。但纳入RCT的文献质量不高,且数量有限,今后尚需开展更多大样本的高质量研究加以验证。

A Meta Analysis of the Effect of External Therapy of TCM on Gastrointestinal Function Recovery After Gastrointestinal Tumor Surgery

Objective:To systematically evaluate the clinical effect of external therapy of TCM on gastrointestinal function recovery after gastrointestinal tumor surgery.Methods:China National Knowledge Network(CNKI),China biomedical literature database,VIP information,Wanfang database and PubMed were searched by computer from the establishment of the database to December 2019.The randomized controlled trials(RCT)of the effect of external therapy of TCM on the recovery of gastrointestinal function after gastrointestinal tumor surgery were searched.Revman 5.3 software was used for data analysis and quality evaluation.Results:Finally,a total of 17 RCT studies were included,involving 1,388 patients,including 699 ones in the observation group and 689 ones in the control group.The results of Meta-analysis showed that the effective rate of external therapy of TCM on gastrointestinal function recovery was higher than that of conventional Western medicine treatmentOR=5.00,95%CI(2.93,8.53),P<0.00001],and the recovery time of anal exhaustSMD=-2.33,95%CI(-2.99,-1.66),P<0.00001]and anal defecation recovery timeSMD=-2.18,95%CI(-2.98,-1.37),P<0.00001]],recovery time of bowel soundsSMD=-2.29,95%CI(-2.91,-1.66),P<0.00001],gastric tube indwelling timeSMD=-1.72,95%CI(-2.82,-0.62),P=0.002],diet recovery timeSMD=-0.70,95%CI(-1.09,-0.31),P=0.0004]and hospitalization timeSMD=-1.92,95%CI(-2.52,-1.33),P<0.00001]in the observation group were all shorter than those of the control group,and all the differences were statistically significant(P<0.05).Conclusion:The clinical effective rate of external therapy of TCM on gastrointestinal function recovery after gastrointestinal tumor surgery was higher than that of Western medicine alone,and the improvement of main clinical symptoms in the observation group was better than that in the control group.However,the quality of the included RCT literature is not high and the quantity is limited.In the future,more and larger sample high-quality studies should be needed to verify.