【摘要】 目的对中医外治法治疗帕金森病便秘的临床效果进行系统评价。方法计算机检索CNKI、万方、维普、CBM、Cochrane Library、PubMed等数据库中运用中医外治法治疗帕金森病便秘的随机对照研究(RTC),自建库至2018年9月30日发表的文献均纳入检索范围。RTC中观察组采用中医外治法+常规治疗/其他治疗,对照组采用常规治疗/(除中医外治法)其他治疗。采用RevMan 5.3软件进行Meta分析中医外治法治疗帕金森病便秘的临床效果。结果共纳入11项研究833例患者,其中观察组417例的对照组416例。Meta分析结果显示:两组临床疗效总有效率[RR=1.24,95%CI(1.11,1.39),P=0.0002]、治愈率[RR=1.77,95%CI(1.40,2.23),P <0.000 01]、便秘症状积分[MD=-1.41,95%CI(-2.10,-0.71),P <0.0001]比较,差异均有统计学意义;而两组直肠静息压[SMD=0.23,95%CI(-0.72,1.19),P=0.63]、肛管静息压[SMD=-0.13,95%CI(-0.56,0.29),P=0.54]、肛管收缩压[SMD=0.22,95%CI(-0.17,0.62),P=0.26]比较,差异无统计学意义。结论中医外治法能明显改善帕金森病便秘症状,其临床疗效确切,具有良好的应用前景。但因为纳入文献质量不高,样本量亦偏少,所以仍需更多大样本、多中心、设计严谨、高质量、双盲的RCT来进一步验证其有效性。更多还原

【Abstract】 Objective To systematically evaluate the clinical efficacy of external treatments of traditional Chinese medicine(TCM) for constipation of Parkinson′s disease. Methods The randomized controlled trials(RTCs) about external treatment of TCM for constipation of Parkinson′ s disease in databases such as CNKI, Wan fang, VIP, CBM,Cochrane Library, PubMed were searched by computer, and all literatures published from their establishment to September 30, 2018 were included. In the RTCs, external treatment + conventional treatment/other treatments were used in the observation group and conventional treatment/other treatments were used in the control group. RevMan 5.3 software was used for meta analysis of the clinical efficacy of external treatments of TCM for constipation of Parkinson′s disease. Results Eleven studies involving 833 patients were included, including 417 cases in the observation group and416 cases in the control group. The meta analysis showed that: there was statistically significant difference in the clinical efficiency [RR = 1.24, 95%CI(1.11, 1.39), P = 0.0002], the cure rate [RR = 1.77, 95%CI(1.40, 2.23), P < 0.000 01],and the score of symptoms of constipation [MD =-1.41, 95%CI(-2.10,-0.71), P < 0.0001] between the two groups.There was no statistically significant difference in the pressure of rectal resting [SMD = 0.23, 95%CI(-0.72, 1.19), P =0.63], the pressure of anal resting [SMD =-0.13, 95%CI(-0.56, 0.29), P = 0.54], and the pressure of anal canal systolic[SMD = 0.22, 95%CI(-0.17, 0.62), P = 0.26]. Conclusion The external treatment of TCM can obviously improve the symptoms of constipation in Parkinson′s disease. The clinical efficacy is exact, and it displays a promising application.However, due to the low quality of the literatures included and the small sample size, more large samples, multi-center,well-designed, high-quality, double-blind RCTs are still needed to verify its effectiveness further.更多还原