| Background:Children's Functional abdominal pain(Functional abdominal pain,FAP)refers to a recurrent or persistent abdominal pain,and is not accompanied by physical changes and biochemical abnormalities of Functional gastrointestinal disease.FAP is one of the pediatric clinical common diseases,the prevalence rate of about 4.4%?13.5%.Due to FAP with parents and children work,learning,absenteeism,lower quality of life such as serious adverse effects.Children in the pathophysiology of FAP is main brain-im axis change caused by abnormal gastrointestinal dynamics,visceral high sensitivity,dysfunction of the autonomic nervous system,intestinal dysbacteriosis and other factors.The study found that intestinal flora in the brain-can have a two-way role in regulating intestinal axis,regulating brain-intestinal shaft can become a target for the treatment of FAP in children.Clinical studies have found that probiotics treatment of FAP children have certain curative effect,but has not yet been incorporated into the children's guidelines,and about probiotics in treatment of children's FAP evidence-based research.This study adopts the method of Meta analysis research at home and abroad the latest the clinical curative effect of treating children FAP using probiotics,probiotics in the treatment of FAP will provide certain evidence-based study basis.FAP children belong to the category of "pain" make a diagnosis and give treatment of traditional Chinese medicine,Chinese medicine treatment of FAP clinical research is more,this study will be Chinese traditional medicine and probiotics controls or traditional Chinese medicine combined with probiotics treatment children FAP,summarized the research,research of traditional Chinese medicine therapy,treatment and therapeutic drug law of FAP to combine traditional Chinese and western medicine treatment of children to provide a clinical basis.The first part is to study the Meta analysis of probiotics in the treatment of functional abdominal pain in children.Methods:Formulate retrieval words and retrieval in China hownet,ten thousand,VIP,such as PubMed database retrieval probiotics compared to placebo in both English and Chinese children FAP Randomized controlled trials(Randomized controlled trials,RCT),will get the basic information of the literature screening with Excel table record,and USES the Cochrane collaboration to establish evaluation tool to evaluate the quality of the literature.The collection of two groups of treatment and follow-up in FAP children main outcome indicators(frequency of the degree of abdominal pain,abdominal pain and abdominal pain cure rate,etc.)and the secondary outcome indicators(after treatment duration of abdominal pain,nausea,abdominal distension and other gastrointestinal symptoms,defecate character,intestinal osmotic pressure,caused by abdominal pain with parents and children work,activities,absence of learning,and because of abdominal pain medications,etc.).Use the tools such as Rev Man 5.3 and Stata 14.0 Meta analysis.Results:Were retrieved with 182 references,remove literature after the rest of the 138 papers published in the repeat,again ruled out intervention measures,research objects and research type is not in conformity with the 127 articles,in the end there are 11 into the literature research,a total of 1183 cases,the treatment group of 625 people,the control group of 558 people.Specific as follows:(1)Probiotic treatment of children with FAP was superior to placebo in relieving abdominal pain[P=0.04,SMD=-0.33,95%CI=(-0.64,-0.22)]and cure rate[P=0.005,OR=1.28,95%CI=(1.22,3.09)],but there was no significant difference between placebo and placebo in reducing the frequency of abdominal pain[P=0.05,SMD=-0.70,95%Cl=(-1.40,0.00)]in children treated with probiotics.(2)Although probiotics was superior to placebo in relieving abdominal pain in children with FAP,Meta analysis showed that I2>50%,suggesting high heterogeneity and low credibility,so subgroup analysis was conducted to find the sources of heterogeneity according to the course of treatment of the study,when the course of treatment was 4 weeks,there was no significant difference between probiotics and placebo in relieving abdominal pain in children's FAP[P=0.85,MD=0.05,95%CI=(-0.43,0.53)].When the course of treatment was 8 weeks,the degree of relief of abdominal pain in children treated with probiotics was better than that of placebo in the degree of relieving abdominal pain[P=0.0002,MD=-0.36,95%CI=(-0.56,-0.17)].When the course of treatment was 12 weeks,the degree of relief of abdominal pain in children treated with probiotics was better than that of placebo[P=0.000001,MD=-0.18,95%CI=(-0-25,-0.10)].Some of these studies also followed up for 4-8 weeks after treatment.(3)Meta analysis showed that during follow-up,probiotic treatment of children with FAP was superior to placebo in relieving abdominal pain[P=0.04.SMD=-0.66.95%CI=(-1.27,-0.04)].The degree of relief of abdominal pain in children treated with probiotics was not better than that of placebo in reducing the frequency of abdominal pain[P=0.72,SMD=-0.07,95%CI=(-0.43,0.30)].There was no significant difference between probiotics and placebo(4)As for other secondary outcomes that could not be included in Meta analysis,studies have documented that probiotics are superior to placebo in reducing the duration of abdominal pain,abdominal distension and nausea in children with FAP.In other secondary outcomes,such as improving stool traits,reducing daily activities and school absenteeism,improving intestinal permeability,reducing the frequency of medication due to abdominal pain and parents' work absenteeism caused by abdominal pain,there was no significant difference between probiotics and placebo.The second part is the analysis of the diagnosis and treatment of functional abdominal pain in children with traditional Chinese medicine.Methods:Formulate retrieval words and retrieval in China hownet,ten thousand,VIP.such as PubMed database retrieval in both Chinese and English oral medicine or oral medicine combined probiotics compared to traditional Chinese medicine or therapy to treat other children of FAP randomized controlled trial,will get the basic information of the literature screening with Excel table records,establishing database of traditional Chinese medicine,the therapy and the treatment according to the therapeutic principle of single drug use frequency,efficacy,medicinal properties,ingredients,drug by statistical analysis Results:A total of 306 articles were searched in the database.After reading the title,abstract or full text according to the inclusion and exclusion criteria,a total of 42 articles were included,including 17 kinds of treatment principles.42 prescriptions and 68 traditional Chinese medicines.In the treatment of children's FAP,regulating qi.invigorating the spleen,harmonizing stomach and digestion are the most frequently used,with a cumulative frequency of 62%.In the treatment of children's FAP,there are mainly deficiency-tonifying drugs such as licorice,white peony and Atractylodes macrocephala,qi-regulating drugs such as Corydalis and wood incense,and digestive drugs such as Hawthorn.In the efficacy of traditional Chinese medicine for the treatment of FAP in children,the top 10 Chinese medicines are mainly deficiency-tonifying drugs,qi-regulating drugs,food-dispelling drugs and dampness-removing drugs;in the treatment of children's FAP,warm drugs are mainly used,with a cumulative frequency of 46.97%.In the taste of traditional Chinese medicine for the treatment of FAP in children,pungent drugs are used most frequently,followed by bitter and sweet medicines,with a cumulative frequency of 84.76%.In the meridian tropism of traditional Chinese medicine for the treatment of FAP in children,the drugs of spleen,stomach,lung meridian and liver meridian are the most,with a cumulative frequency of 72.37%.Conclusion:Probiotic children can FAP abdominal pain relief of abdominal pain and improve the cure rate.Chinese medicine has its specific diagnosis and treatment in treating children FAP.Together Chinese and western medicine treatment could improve the clinical curative effect of children FAP. |
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