世界中医药
文章摘要
中药贴敷神阙治疗阿片类药物相关性便秘疗效的系统评价
Efficacy of Traditional Chinese Medicine Application to Shenque(RN 8)in the Treatment of Opioid-related Constipation:A Systematic Review
投稿时间:2018-07-26  
DOI:10.3969/j.issn.1673-7202.2019.07.013
中文关键词: 阿片类药物相关性便秘  止痛药  中药贴敷  穴位贴敷    神阙  Meta分析  系统评价
英文关键词: Opioid-related constipation  Analgesic  Traditional Chinese medicine application  Acupoint application  Navel  Shenque(RN 8)  Meta analyse  Systematic review
基金项目:重庆市科研院所绩效激励引导专项(cstc2017jxjl0114)
作者单位
宋娜1,赖宗浪1,程俊1,黎颖1,孟令占1,赵西位1,李菊影1,阳瑜琳1,甘芷川2 1 重庆市中医院,重庆,400021
2 广西国际壮医医院,南宁,530021 
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中文摘要:
      目的:本研究系统评价了中药贴敷神阙治疗癌症患者阿片类药物相关性便秘的疗效和安全性,以期为临床治疗提供一定参考。方法:计算机检索PubMed、EMBase、Cochrane Library、CNKI、维普网和万方数据库,收集中药贴敷神阙治疗癌症患者阿片类药物相关性便秘的RCT,按照标准提取资料,根据Cochrane手册5.1.0评价文献质量后采用RevMan 5.3软件进行Meta分析。结果:纳入22篇文献,包含1 777例患者。Meta分析示,中药贴敷神阙治疗癌症患者阿片类药物相关性便秘疗效明显,差异有统计学意义(RR=1.15,95%CI[1.06,1.26])。亚组分析示:贴敷组较护理组、贴敷联合其他外治组较标准观察组有效率提高{RR=1.35,95%CI[1.24,1.48];RR=1.34,95%CI[1.20,1.48]}。贴敷+酚酞片VS酚酞片、贴敷+乳果糖VS乳果糖差异无统计学意义,但有提高疗效的可能性{RR=1.20,95%CI[1.00,1.43];RR=1.19,95%CI[0.94,1.49]},7篇文献报道了不良反应,示不良反应较轻,治疗安全。结论:中药贴敷神阙能有效的治疗恶性肿瘤患者阿片类药物相关性便秘,并能明显提高西药治疗的有效率。受纳入文献质量的限制,本研究尚不能得到较为可靠的结论。
英文摘要:
      To evaluate efficacy and safety of traditional Chinese medicine application to Shenque(RN 8)in the treatment of opioid-related constipation in cancer patients,in order to provide reference for clinical treatment.Methods:Databases include PubMed,EMBase,Cochrane Library,CNKI,VIP and Wanfang were searched for collecting randomized controlled trials(RCTs)about traditional Chinese medicine application to Shenque(RN 8)in the treatment of opioid-related constipation in cancer patients.The data were extracted according to the criteria of inclusion and exclusion,and quality of the included studies was assessed according to the Cochrane Manual 5.1.0.RevMan 5.3 software was used to perform Meta analysis.Results:A total of 22 papers were included,including 1777 cases of patients.The results of Meta analysis showed a positive effect of traditional Chinese medicine application to Shenque(RN 8)in the treatment of opioid-related constipation in cancer patients,with a statistically significant difference(RR=1.15,95% CI[1.06,1.26]).The results of subgroup Meta analysis showed that effective rate in the application group was higher than that in the nursing group,and that in the application+other external treatment group was higher than that in the standard treatment group(RR=1.35,95% CI[1.24,1.48]; RR=1.34,95% CI[1.20,1.48]).There was no statistical difference between the application+Phenolphthalein Tablets group and the Phenolphthalein Tablets group,as well as the application+lactulose group and the lactulose group.But the combined treatment showed a possibility of improving the efficiency(RR=1.20,95% CI[1.00,1.43]; RR=1.19,95% CI[0.94,1.49]).There were 7 papers reporting the occurrence of side effects,which showed that the side effects were mild and the treatment was safe.Conclusion:Traditional Chinese medicine application to Shenque(RN 8)is effective to treat opioid-related constipation in patients with cancer,and it can significantly improve the effective rate of western medicine treatment.However,this conclusion has bias because of the limitation of the quality of included literature.
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