世界中医药

基金项目:上海市卫生和计划生育委员会中医药科研基金项目（编号：2014LP087A）；上海市卫生和计划生育委员会中医药科研基金项目（编号：20124043）；浦东新区卫生局联合攻关项目（编号：PW2013D-10）；浦东新区中医药事业发展专项资金项目“院内制剂和经验方规范化临床验证”（编号：PDYNZJ2014-31）；上海中医药大学附属龙华医院基金资助项目（编号：2014YM11）

作者	单位
董青军，梁宏涛，姚一博，潘一滨，张强，殷立新，王琛，郭修田，曹永清，陆金根	上海中医药大学附属龙华医院，上海，200032

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中文摘要:

目的：系统评价国内拖线或拖线联合辅助疗法治疗肛瘘的临床疗效性及安全性。方法：计算机检索CNKI（2005—2012）；VIP、社科期刊数据库（2005—2012）；WanFang Data、博硕士论文、会议论文数据库（2005—2012）和中国生物医学文献服务系统（2005—2012）数据库，查找拖线术为主治疗肛瘘的随机对照试验（RCT），同时追溯相关文献的参考文献。按照纳入和排除标准筛选文献、提取资料和评价质量后，采用RevMan4.2软件进行Meta-分析。结果：共纳入12个RCT，Meta-分析结果显示：拖线术能有效提高肛瘘的治疗效果，减少肛门失禁，保护肛门功能，与传统肛瘘切开和/或切开挂线术相比，其差异均有统计学意义（P<0.01）。结论：现有循证医学证据显示拖线术能有效地保护肛门功能，提高肛瘘的一次性治愈率。但受纳入研究数量和质量限制，上述结论尚需开展更多大样本的随机对照试验加以验证。

English Summary:

To evaluate the efficacy and safety of thread-dragging through fistula method (TDFM) in treating patients with anal fistula.Methods: Databases such as CNKI (2005 to 2012),VIP (2005 to 2012) and Wanfang Data (2005 to 2012) etc.were electronically searched for randomized controlled trials (RCTs) on different surgical (basing on TDFM ) treatments for anal fistula,and the relevant references were also retrieved.According to the inclusion and exclusion criteria,we screened literature,extracted data,and critically assessed the quality of RCTs.Then the meta-analysis was conducted using RevMan 4.2 software.Results: A total of 12 RCTs were included.The results of meta-analyses showed that TDFM could improve efficacy,reduce fecal incontinence,protect anal function (P<0.01).Conclusion: Current evidence shows TDFM can effectively improve efficacy,protect anal function.But this conclusion still needs to be proven by large-scale RCTs due to the limited quantity and quality of the included studies.

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