中医外治法治疗急性放射性肠炎的Meta分析及试验序贯分析

目的:系统评价中医外治法治疗急性放射性肠炎的临床疗效和安全性.方法:通过检索万方数据库、中国知网、重庆维普数据库、中国生物医学文献数据库、PubMed、Embase、Cochrane Library等,收集中医外治法(包括中药保留灌肠、针灸、穴位注射等)对比常规西药治疗急性放射性肠炎的随机对照试验(RCT),采用Coc...

Traditional Chinese Medicine External Therapy for the Treatment of Acute Radiation Enteritis:A Meta-Analysis and Trial Sequential Analysis

Objective:To systematically evaluate the clinical efficacy and safety of Traditional Chinese Medicine(TCM)external therapy for the treatment of acute radiation enteritis.Methods:We searched Wanfang database,CNKI,Chongqing VIP database,CBM,PubMed,Embase and Cochrane Library,and then collected the randomized controlled trial(RCT)of TCM external therapy(including retention enema,acupuncture and acupoint injection)compared with conventional western medicine in the treatment of acute radiation enteritis.Cochrane risk bias assessment tool was used to evaluate the methodological quality of the final included study.The data was extracted and then RevMan 5.3 software was used for meta-analysis.And funnel chart test was used to evaluate the publication bias.TSA 0.9 software was used for Trial Sequential Analysis.Results:Totally 14 RCTs were included,involving 1036 patients.According to the results of meta-analysis,the treatment group showed higher effective rate than control group[OR=4.88,95%CI(3.38,7.04),P<0.00001].The treatment group showed better abdominal pain score[MD=-0.76,95%CI(-1.43,-0.09),P=0.03],diarrhea score[MD=-0.50,95%CI(-0.62,-0.39),P<0.00001],mucopurulent bloody stool score[MD=-0.38,95%CI(-0.47,-0.29),P<0.00001],tenesmus score[MD=-0.48,95%CI(-0.59,-0.38),P<0.00001],KPS[MD=7.37,95%CI(4.06,10.68),P<0.0001]and intestinal mucosa score[MD=-1.29,95%CI(-2.10,-0.48),P=0.002]than control group.And the treatment group showed lower IL-1 level than control group[MD=-4.57,95%CI(-6.85,-2.30),P<0.0001].No serious adverse reactions occurred in both groups.The TSA showed that the evidence of therapeutic effect of external therapy of TCM on acute radiation enteritis is accurate.Conclusion:The therapeutic effect of external treatment of TCM on acute radiation enteritis may be better than that of conventional western medicine,and the adverse reactions are less.Howe ver,this conclusion still needs to be verified by a larger sample,multicenter,different race,longer follow-up time and high-quality randomized controlled trial.