| Objective:To systematically evaluate the clinical efficacy and safety of t he integrated Chinese and Western medicine therapy in treating irritable bowe l syndrome by means of evidence-based medicine methods.Methods:PubMed,Cochrane library,VIP,CNKI and Wanfang data,(Jan.1,2013 to Dec.30,2017)were systematically searched for randomized controlled trials(RCTs)which about integrated Chinese and Western medicine therapy in treating irritable bowel syndrome comparison of simple western medicine or simple Chinese Medicine.The literature were filtrated by the evaluators in accordance with the established inclusion and elimination standards,and the quality assessment was carried out through the modified version of the Jadad table.Data including total effective rate of clinical treatment,cure rate,improvement of the main symptoms(abdominal pain,diarrhea,abdominal distention,stool character,stool number),anxiety and depression scale(SAS,SDS,HAMA,HAMD),Interleukin-8(IL-8),Brain gut peptide P(SP),adverse reaction,recurrence rate were extracted for a Meta-analysis through the software RevMan5.3.5 that provided by Cochrane Collaboration.Results:Data processing and meta-analysis were carried out in 44 trials involving 4149 patients after filtrating.Results show as follows:(1)Therapycombined Chinese with Western medicine for IBS was proved to be more effective than Western medicine alone as significant difference were found in data between the two groups including cure rate and total effective rate of clinical treatment[P<0.01,OR=4.27,95%CI:3.40~5.36],[P<0.01,OR=2.30,95%CI:1.87~2.81],improve the main symptoms(abdominal pain,abdominal distention,diarrhea,stool character,stool number)[P<0.01,MD=-0.71,95%CI:-0.74~-0.69],[P<0.01,MD=-0.71,95%CI:-0.72~-0.69],[P<0.01,MD=-0.46,95%CI:-0.57~-0.34],[P<0.01,MD=-0.43,95%CI:-0.50~-0.35],[P<0.01,MD=-0.48,95%CI:-0.56~-0.40],improve neuropsychiatric symptoms(SAS,SDS,HAMA,HAMD scale)[P<0.01,MD=-9.54,95%CI:-10.28~-8.79],[P<0.01,MD=-9.02,95%CI:-9.78~-8.26],[P<0.01,MD=-2.94,95%CI:-3.12~-2.76],[P<0.01,MD=-2.28,95%CI:-3.11~-1.46],Reduce the level of IL-8 and SP[P<0.01,MD=-0.66,95%CI:-0.78~-0.54],[P<0.01,MD=-10.18,95%CI:-13.95~-6.42],Reduce the incidence of adverse reactions[P<0.01,OR=0.43,95%CI:0.25~0.74],recurrence rate was lower than that of the simple western medicine group in January,February,March and June after stopping drug[P<0.05,OR=0.25,95%CI:0.08~0.73],[P<0.01,OR=0.16,95%CI:0.07~0.38],[P<0.01,OR=0.28,95%CI:0.15~0.52],[P<0.01,OP=0.18,95%CI:0.07~0.47].(2)Therapy combined Chinese with Western medicine for IBS was proved to be more effective than traditional Chinese medicine alone as significant difference were found in data between the two groups including cure rate and total effective rate of clinical treatment[P<0.01,OR=4.07,95%CI:2.32~7.13],[P<0.05,OR=2.36,95%CI:1.09~5.09],no difference was found in data between the two groups in the incidence of adverse reactions[P>0.05,OR=0.66,95%CI:0.13~3.40].Conclusions:Through Meta-analysis of the documentary evidence,suchconclusion is drawn:(1)The combination of Chinese and Western medicine is more effective than western medicine alone,which can better improve the main symptoms(abdominal pain,abdominal distension,diarrhea,stool traits,stool frequency abnormalities,etc.)and neuropsychiatric symptoms,and reduce the incidence of adverse reactions and recurrence rate.(2)The combination of Chinese and Western medicine has higher curative effect than pure Chinese medicine,but there is no significant difference in the incidence of adverse reaction.Because of the limited cases and low literature quality,the reliability of the conclusions in this study isn’t completely enough and it needs going on to be evaluated with more large sample and high quality researchs. |
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