Chinese Herbal Enema plus Gastrointestinal Intubation for Ileus: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

 马越 ¹ ,  孟繁洁 ² , 靳英辉 ² , 赵赛 ¹ ,  MAYue ¹ ,  MENGFan-jie ² , JINYing-hui ² , ZHAOSai ¹

1. ;
2. ;
1. ;
2. ;

Corresponding author：

马越, Email: mayue0316@163.com; 孟繁洁, Email: mfj1127@126.com; MAYue, Email: mayue0316@163.com; MENGFan-jie, Email: mfj1127@126.com

Keywords：

Ileus; Chinese herbal; Enema; Gastrointestinal intubation; Systematic review; Meta-analysis

DOI：

10.7507/1672-2531.20140202

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To systematically review the efficacy of Chinese herbal enema in ileus patients. Methods The randomized controlled trials (RCTs) and quasi-RCTs about Chinese herbal enema and gastrointestinal intubation versus western medicines in the treatment of ileus disease was searched in PubMed, Web of Science, EMbase, The Cochrane Library (Issue 4, 2013), CBM, CNKI, VIP and WanFang Data from the date of their establishment to July 2013. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of included studies. Then meta-analysis was performed using RevMan 5.1. Results A total of 27 RCTs and 3 quasi-RCTs involving 3 074 patients were included. The results of meta-analysis showed that the Chinese herbal enema and gastrointestinal intubation group was superior to the control group in raising the total clinical effective rate (OR=4.69, 95%CI 3.70 to 5.94, P < 0.000 01), as well as shortening the hospitalization time (SMD=-1.19, 95%CI-1.42 to-0.96, P < 0.000 01), time of anus exhaust (SMD=-1.52, 95%CI-1.76 to-1.28, P < 0.000 01), defecation (SMD=-2.27, 95%CI-3.43 to-1.11, P=0.000 1), time of gastric tube indwelling (SMD=-1.56, 95%CI-1.86 to-1.27, P < 0.000 01), and symptoms complete resolution (SMD=-0.74, 95%CI-1.11 to-0.37, P < 0.000 1), all with significant differences. Conclusion Chinese herbal enema and gastrointestinal intubation is more beneficial than western medicine alone for ileus. Due to limited quality of the included studies, the abovementioned conclusion still needs to be verified by conducting more high quality blinding RCTs.

Citation： 马越, 孟繁洁, 靳英辉, 赵赛, MAYue, MENGFan-jie, JINYing-hui, ZHAOSai. Chinese Herbal Enema plus Gastrointestinal Intubation for Ileus: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2014, 14(10): 1254-1262. doi: 10.7507/1672-2531.20140202 Copy

1.	李宁.重视腹部手术后肠梗阻的非手术治疗.中国实用外科杂志, 2008, 28(9):689-691.
2.	黎介寿.认识术后早期炎症性肠梗阻的特征.中国实用外科杂志, 1998, 18(7):387-388.
3.	刘锋, 杨明胜.肠梗阻的中医辨证治疗.光明中医, 2004, 19(6):21-23.
4.	伊永凤.中药灌肠治疗肠梗阻134例.中国民间疗法, 2005, 13(4):28.
5.	中华人民共和国卫生部.中药新药临床研究指导原则(第三辑). 1997:61-62.
6.	Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0[updated March 2011]. The Cochrane Collaboration, 2011. Available at:www.cochrane-handbook.org.
7.	戴院华, 徐志荣.中西医结合治疗粘连性肠梗阻35例.江西中医药, 2009, 40(3):46-47.
8.	方寒柳, 谢景泉, 何琳, 等.中西医结合治疗急性肠梗阻疗效观察.广东医学, 2008, 29(4):680-681.
9.	张吕泉.中西医结合治疗粘连性肠梗阻38例.河北中医, 2005, 27(10):769-769.
10.	张长海.中西医结合治疗粘连性肠梗阻的临床体会.内蒙古中医药, 2011, 30(3):82-83.
11.	顾孝干, 李明宏, 高泽俊.中西医结合治疗粘连性肠梗阻临床观察.辽宁中医药大学学报, 2012, 14(7):238-239.
12.	曾美良.大承气汤加味治疗早期炎性肠梗阻50例.中国现代医生, 2012, 50(22):142-143.
13.	马占英.中西医结合治疗术后粘连性肠梗阻46例.中国民间疗法, 2012, 20(1):53.
14.	汪修保.肠粘连松解汤治疗术后粘连性肠梗阻31例临床分析.中医药临床杂志, 2012, 24(8):745-746.
15.	高海静.中西医结合治疗肠梗阻疗效观察.中国社区医师(医学专业), 2012, 14(2):247.
16.	侯立军.中西医结合治疗粘连性肠梗阻60例.河北中医, 2009, 31(7):1026-1027.
17.	杨春平, 朱锦腾.中西医结合治疗术后急性粘连性肠梗阻39例总结.湖南中医杂志, 2009, 25(2):29-30.
18.	李瑞.应用大承气汤加味治疗腹部术后早期炎性肠梗阻疗效观察.中国中医药信息杂志, 2007, 14(1):59.
19.	张宇, 何清源, 蒋敦厚, 等.复方大承气汤治疗腹部术后早期炎性肠梗阻分析.陕西中医, 2007, 28(1):53-54.
20.	熊少伟.中药治疗粘连性肠梗阻临床疗效分析.中外健康文摘:医药月刊, 2007, 4(6):104-106.
21.	蒋立新.中西医结合治疗术后早期粘连性肠梗阻临床观察.山东医药, 2009, 49(48):55-56.
22.	周云.中药胃管注入及保留灌肠治疗术后早期粘连性肠梗阻的效果观察.中医临床研究, 2009, 1(1):16-17.
23.	邓志刚.中药胃管注入及保留灌肠治疗粘连性肠梗阻的疗效分析.中国医药指南, 2009, 7(9):96-97.
24.	杨国才.中西医结合治疗术后粘连性肠梗阻的临床分析.中国现代医生, 2010, 48(33):181-182.
25.	王德运.中西医结合治疗术后粘连性肠梗阻36例临床分析.中国社区医师(医学专业), 2011, 13(25):176.
26.	丁文涛.粘连性肠梗阻的中西医结合治疗.天津医科大学, 2011.
27.	曾莉, 钱海华, 赵群男, 等.活血通腑方治疗术后粘连性肠梗阻56例临床观察.南京中医药大学学报, 2010, 26(3):178-180.
28.	周海峰, 徐中珍.两种疗法治疗肠梗阻疗效比较.浙江中西医结合杂志, 2006, 16(5):302-303.
29.	肖永刚, 吴毅伟, 王慧敏, 等.提壶揭盖法治疗术后早期炎性肠梗阻42例.陕西中医, 2011, 32(11):1480-1481.
30.	沈建庆.复方大承气汤治疗术后早期炎性肠梗阻.浙江中西医结合杂志, 2005, 15(10):607-608.
31.	袁永华.自拟五磨承气汤为主治疗粘连性肠梗阻30例临床观察.中医药导报, 2007, 13(12):31, 37.
32.	周萍, 谭海彦.中西医结合治疗粘连性肠梗阻22例.中国中西医结合杂志, 2007, 27(3):274-275.
33.	朱林, 余海放, 胡海, 等.中西医结合治疗机械性肠梗阻203例临床分析.中医药导报, 2005, 11(5):29-30.
34.	张彩平, 穆成云.中西医结合治疗术后粘连性肠梗阻疗效观察.现代医药卫生, 2009, 25(13):1993-1994.
35.	黄成宽.中西医结合治疗单纯性粘连性肠梗阻24例的疗效观察.广西医学, 2009, 31(5):754-755.
36.	王文文, 周海峰, 徐中珍, 等. 3种疗法治疗肠梗阻的疗效观察.现代中西医结合杂志, 2007, 16(1):48.
37.	Cirocchi R, Abraha I, Farinella E, et al. Laparoscopic versus open surgery in small bowel obstruction. Cochrane Database Syst Rev, 2010, (02):CD007511.
38.	Abbas S, Bissett IP, Parry BR. Oral water soluble contrast for the management of adhesive small bowel obstruction. Cochrane Database Syst Rev, 2007, (3):CD004651.
39.	Wadani HA, AlAwad NI, Hassan KA, et al. Role of water soluble contrast agents in assigning patients to a non-operative course in adhesive small bowel obstruction. Oman Med J, 2011, 26(6):454-456.
40.	Wang LS, Liu JP, Han M, et al. Acupoint stimulation for postoperative ileus following gastrointestinal surgery. Cochrane Database Syst Rev, 2012, (12):CD010279.
41.	陈育中.通腑泻热灌肠合剂对粘连性肠梗阻肠免疫屏障保护作用.广州:广州中医药大学, 2012.
42.	Bosio RM, Delaney CP, Senagore AJ. Economic impact of POI and prolonged length of stay. Seminars in Colon and Rectal Surgery, 2005, 16(4):235-238.
43.	刘涛.中医三联疗法在粘连性肠梗阻围手术期的临床应用研究.广州:广州中医药大学, 2008.
44.	郝蕾.通腑泻热灌肠合剂对粘连性肠梗阻肠屏障保护作用.广州:广州中医药大学, 2012.
45.	杨杰.大承气汤在治疗肠梗阻中的应用.实用中医内科杂志, 2010, 24(12):71-72.
46.	姬志伟, 罗连城, 薛文斗.大承气冲剂对腹腔感染家兔肠血流量的影响.中国中西医结合外科杂志, 2000, 6(4):58-60.
47.	石桂珍, 徐淑华.大承气汤的临床应用.内蒙古中医药, 2010, 29(3):83-84.
48.	黎贵湘, 陈本会, 程桂兰, 等.中西医结合治疗粘连性肠梗阻的护理.齐齐哈尔医学院学报, 2003, 24(1):52-53.

1. 李宁.重视腹部手术后肠梗阻的非手术治疗.中国实用外科杂志, 2008, 28(9):689-691.
2. 黎介寿.认识术后早期炎症性肠梗阻的特征.中国实用外科杂志, 1998, 18(7):387-388.
3. 刘锋, 杨明胜.肠梗阻的中医辨证治疗.光明中医, 2004, 19(6):21-23.
4. 伊永凤.中药灌肠治疗肠梗阻134例.中国民间疗法, 2005, 13(4):28.
5. 中华人民共和国卫生部.中药新药临床研究指导原则(第三辑). 1997:61-62.
6. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0[updated March 2011]. The Cochrane Collaboration, 2011. Available at:www.cochrane-handbook.org.
7. 戴院华, 徐志荣.中西医结合治疗粘连性肠梗阻35例.江西中医药, 2009, 40(3):46-47.
8. 方寒柳, 谢景泉, 何琳, 等.中西医结合治疗急性肠梗阻疗效观察.广东医学, 2008, 29(4):680-681.
9. 张吕泉.中西医结合治疗粘连性肠梗阻38例.河北中医, 2005, 27(10):769-769.
10. 张长海.中西医结合治疗粘连性肠梗阻的临床体会.内蒙古中医药, 2011, 30(3):82-83.
11. 顾孝干, 李明宏, 高泽俊.中西医结合治疗粘连性肠梗阻临床观察.辽宁中医药大学学报, 2012, 14(7):238-239.
12. 曾美良.大承气汤加味治疗早期炎性肠梗阻50例.中国现代医生, 2012, 50(22):142-143.
13. 马占英.中西医结合治疗术后粘连性肠梗阻46例.中国民间疗法, 2012, 20(1):53.
14. 汪修保.肠粘连松解汤治疗术后粘连性肠梗阻31例临床分析.中医药临床杂志, 2012, 24(8):745-746.
15. 高海静.中西医结合治疗肠梗阻疗效观察.中国社区医师(医学专业), 2012, 14(2):247.
16. 侯立军.中西医结合治疗粘连性肠梗阻60例.河北中医, 2009, 31(7):1026-1027.
17. 杨春平, 朱锦腾.中西医结合治疗术后急性粘连性肠梗阻39例总结.湖南中医杂志, 2009, 25(2):29-30.
18. 李瑞.应用大承气汤加味治疗腹部术后早期炎性肠梗阻疗效观察.中国中医药信息杂志, 2007, 14(1):59.
19. 张宇, 何清源, 蒋敦厚, 等.复方大承气汤治疗腹部术后早期炎性肠梗阻分析.陕西中医, 2007, 28(1):53-54.
20. 熊少伟.中药治疗粘连性肠梗阻临床疗效分析.中外健康文摘:医药月刊, 2007, 4(6):104-106.
21. 蒋立新.中西医结合治疗术后早期粘连性肠梗阻临床观察.山东医药, 2009, 49(48):55-56.
22. 周云.中药胃管注入及保留灌肠治疗术后早期粘连性肠梗阻的效果观察.中医临床研究, 2009, 1(1):16-17.
23. 邓志刚.中药胃管注入及保留灌肠治疗粘连性肠梗阻的疗效分析.中国医药指南, 2009, 7(9):96-97.
24. 杨国才.中西医结合治疗术后粘连性肠梗阻的临床分析.中国现代医生, 2010, 48(33):181-182.
25. 王德运.中西医结合治疗术后粘连性肠梗阻36例临床分析.中国社区医师(医学专业), 2011, 13(25):176.
26. 丁文涛.粘连性肠梗阻的中西医结合治疗.天津医科大学, 2011.
27. 曾莉, 钱海华, 赵群男, 等.活血通腑方治疗术后粘连性肠梗阻56例临床观察.南京中医药大学学报, 2010, 26(3):178-180.
28. 周海峰, 徐中珍.两种疗法治疗肠梗阻疗效比较.浙江中西医结合杂志, 2006, 16(5):302-303.
29. 肖永刚, 吴毅伟, 王慧敏, 等.提壶揭盖法治疗术后早期炎性肠梗阻42例.陕西中医, 2011, 32(11):1480-1481.
30. 沈建庆.复方大承气汤治疗术后早期炎性肠梗阻.浙江中西医结合杂志, 2005, 15(10):607-608.
31. 袁永华.自拟五磨承气汤为主治疗粘连性肠梗阻30例临床观察.中医药导报, 2007, 13(12):31, 37.
32. 周萍, 谭海彦.中西医结合治疗粘连性肠梗阻22例.中国中西医结合杂志, 2007, 27(3):274-275.
33. 朱林, 余海放, 胡海, 等.中西医结合治疗机械性肠梗阻203例临床分析.中医药导报, 2005, 11(5):29-30.
34. 张彩平, 穆成云.中西医结合治疗术后粘连性肠梗阻疗效观察.现代医药卫生, 2009, 25(13):1993-1994.
35. 黄成宽.中西医结合治疗单纯性粘连性肠梗阻24例的疗效观察.广西医学, 2009, 31(5):754-755.
36. 王文文, 周海峰, 徐中珍, 等. 3种疗法治疗肠梗阻的疗效观察.现代中西医结合杂志, 2007, 16(1):48.
37. Cirocchi R, Abraha I, Farinella E, et al. Laparoscopic versus open surgery in small bowel obstruction. Cochrane Database Syst Rev, 2010, (02):CD007511.
38. Abbas S, Bissett IP, Parry BR. Oral water soluble contrast for the management of adhesive small bowel obstruction. Cochrane Database Syst Rev, 2007, (3):CD004651.
39. Wadani HA, AlAwad NI, Hassan KA, et al. Role of water soluble contrast agents in assigning patients to a non-operative course in adhesive small bowel obstruction. Oman Med J, 2011, 26(6):454-456.
40. Wang LS, Liu JP, Han M, et al. Acupoint stimulation for postoperative ileus following gastrointestinal surgery. Cochrane Database Syst Rev, 2012, (12):CD010279.
41. 陈育中.通腑泻热灌肠合剂对粘连性肠梗阻肠免疫屏障保护作用.广州:广州中医药大学, 2012.
42. Bosio RM, Delaney CP, Senagore AJ. Economic impact of POI and prolonged length of stay. Seminars in Colon and Rectal Surgery, 2005, 16(4):235-238.
43. 刘涛.中医三联疗法在粘连性肠梗阻围手术期的临床应用研究.广州:广州中医药大学, 2008.
44. 郝蕾.通腑泻热灌肠合剂对粘连性肠梗阻肠屏障保护作用.广州:广州中医药大学, 2012.
45. 杨杰.大承气汤在治疗肠梗阻中的应用.实用中医内科杂志, 2010, 24(12):71-72.
46. 姬志伟, 罗连城, 薛文斗.大承气冲剂对腹腔感染家兔肠血流量的影响.中国中西医结合外科杂志, 2000, 6(4):58-60.
47. 石桂珍, 徐淑华.大承气汤的临床应用.内蒙古中医药, 2010, 29(3):83-84.
48. 黎贵湘, 陈本会, 程桂兰, 等.中西医结合治疗粘连性肠梗阻的护理.齐齐哈尔医学院学报, 2003, 24(1):52-53.

Chinese Journal of Evidence-Based Medicine

Chinese Herbal Enema plus Gastrointestinal Intubation for Ileus: A Systematic Review

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