Objective To evaluate the effectivenss of Chinese herbal retention enema in viral hepatitis patients. Methods Such databases as The Cochrane library, PubMed, EMbase, VIP, CNKI, CBM and WanFang Data were searched from the inception to December, 2011 to collect the randomized controlled trials (RCTs) about Chinese herbal retention enema in treating viral hepatitis, and the references of the included literature were also retrieved. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and evaluated and cross-checked the methodological quality. Then meta-analysis was conducted using RevMan 5.0 software. Results A total of 20 RCTs involving 1 735 patients were included. The subgroup analyses based on the length of intervention time showed that: a) after 2-week intervention: the overall effective rate of the Chinese herbal retention enema group was higher than that of the control group, with a significant difference (OR=3.19, 95%CI 1.87 to 5.44, Plt;0.000 1). Compared with the control group, the Chinese herbal retention enema group better promoted the recovery of liver function by more reduction of AST (MD= ?82.50, 95%CI ?145.66 to ?19.34, P=0.01), ALT (MD= ?44.78, 95%CI 65.90 to ?23.66, Plt;0.000 1) and TBIL (MD= ?37.51, 95%CI ?74.07 to ?0.95, Plt;0.0001). b) After 1-month intervention: The overall effective rate of the Chinese herbal retention enema group was higher than that of the control group, with a significant difference (OR=4.17, 95%CI 2.37 to 7.32, Plt;0.000 01). Compared with the control group, the Chinese herbal retention enema group better promoted the recovery of liver function by more reduction of AST (MD= ?17.86, 95%CI ?29.97 to ?5.76, P=0.004), ALT (MD= ?27.84, 95%CI ?42.45 to ?13.24, P=0.000 2), and TBIL (MD= ?54.15, 95%CI ?116.52 to ?8.23, P=0.09). Conclusion Chinese herbal retention enema can improve the overall effective rate for viral hepatitis patients, alleviate virus damage to liver cell and promote liver function recovery. The commonly used Chinese medicinals for enema are Radix et Rhizoma Rhei, Herba Artemisiae Capillaris, Salvia miltiorrhiza, and Radix Paeoniae Rubra.
ObjectiveTo evaluate the efficacy of western conventional treatment based on traditional Chinese medicine retention enema on patients with hepatic encephalopathy. MethodsSuch databases as the Cochrane Library, PubMed, EMbase, VIP, CNKI, CBM and WanFang Database were searched from the inception to November 2013 to collect randomized controlled trials (RCTs) about Western conventional treatment based on traditional Chinese medicine retention enema to treat hepatic encephalopathy, and the references of the included literature were also retrieved. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and evaluated and cross-checked the methodological quality. Then meta-analysis was conducted using RevMan 5.1 software. ResultsA total of 26 RCTs involving 1 691 patients were included. The subgroup analyses based on the length of intervention time showed that when the course of treatment intervention was less than one, the overall effective rate of the Chinese herbal retention enema group was higher than that of the control group, with a significant difference[RR=1.34, 95%CI (1.25, 1.44), P<0.000 01]; after more than one course of treatment intervention, the overall effective rate of the Chinese herbal retention enema group was higher than that of the control group, with a significant difference[RR=1.34, 95%CI (1.21, 1.48), P<0.000 01]. ConclusionOn the basis of available evidence, the western medicine treatment based on traditional Chinese medicine retention enema for hepatic encephalopathy has a certain effect. However, the heterogeneity among the included studies is large. It is necessary to design multicenter, strictly randomized and double-blind test controlled trials with large samples to validate these conclusions and to further confirm the clinical curative effect.
ObjectiveTo evaluate the traditional Chinese medicine fumigation curative effect for the treatment of various diabetic peripheral neuropathy. MethodsDatabases such as China Biology Medicine Database, VIP, China Knowledge Resource Integrated Database, WanFang Data, PubMed, Embase, and the Cochrane Library were searched by computer for controlled clinical trials consistent with the inclusive criteria from the establishment of these databases until February 2016. The literature quality evaluation method of Cochrane system evaluation manual was used to evaluate the methodological quality of the studies, and then relevant data were extracted for Meta-analysis with RevMan 5.1 software. ResultsA total of 15 randomized controlled trials involving 1579 patients were included. Meta-analysis showed that 15 days after intervention, the total effective rate of the traditional Chinese medicine fumigation group was higher than that of the western medicine group, and the difference between the two groups was statistically significant [RR=1.39, 95%CI (1.25, 1.55), P<0.00001]; one month after intervention, the total effective rate of the traditional Chinese medicine fumigation group was significantly higher than that of the western medicine group [RR=1.26, 95%CI (1.15, 1.38), P<0.00001]; two months after intervention, the total effective rate of the traditional Chinese medicine fumigation group was significantly higher than that of the western medicine group [RR=1.22, 95%CI (1.10, 1.36), P=0.0002]. After 1 month of treatment, motor nerve conduction velocity motion [WMD=4.42 m/s, 95%CI (3.40, 5.43) m/s, P<0.00001] and median nerve sensory nerve conduction velocity [WMD=4.02 m/s, 95%CI (2.96, 5.08) m/s, P<0.00001] increased significantly more in the traditional Chinese medicine fumigation group. ConclusionThe Chinese medicine fumigation treatment of diabetic peripheral neuropathy is better than oral or intramuscular vitamin B12, vitamin B1, oral oryzanol and so on.
ObjectiveTo systematically review the effect of doula delivery on postpartum depression.MethodsWe searched The Cochrane Library, Web of Science, PubMed, EMbase, CBM, CNKI and WanFang Data databases to collect relevant randomized controlled trials (RCTs) about the effect of doula delivery on postpartum depression from inception to March 24th, 2017. Two reviewers independently screened literatures, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 19 RCTs involving 10 921 participants were included. The results of meta-analysis showed that the doula delivery could reduce the incidence of postpartum depression (RR=0.36, 95%CI 0.29 to 0.46, P<0.001), and SDS score in doula delivery group was superior to that in the control group (MD=–7.37, 95%CI –11.01 to –3.72, P<0.001).ConclusionThe current evidence shows that doula delivery can reduce the incidence of postpartum depression. Due to the limited quantity and quality of included studies, the above conclusion is still needed to be verified by more high quality studies.
Objective To evaluate the quality of evidence of systematic reviews or meta-analyses regarding outcomes in nursing field in China using the Grade system, so as to get known of the status of the quality of evidence and promote the application of the evaluation of the quality of evidence of systematic reviews. Methods The quality of evidence regarding the included outcomes was input, extracted and qualitatively graded, using GRADEpro 3.6 software. Then, we carefully analyzed and elaborated the factors of downgrading and upgrading that affects the quality of evidence in the process of evaluation. Results 53 systematic reviews or meta-analyses involving 188 outcomes were identified and evaluated. The results showed that high, moderate, low and very low levels of quality of evidence were 2.7%, 27.1%, 51.1%, and 19.1%, respectively; and low-level quality of evidence accounted for the most. Conclusion The quality of evidence produced by systematic reviews or meta-analyses in nursing field in China is poor and urgently needs improvement. The reviewers should abide by the methodological standards in the process of making systematic reviews or meta-analyses. The quality of evidence in terms of each outcome should be evaluated and fully reported.
ObjectiveTo systematically review the effect of early moxibustion therapy on the recovery of gastrointestinal functioning after gastrointestinal surgery. MethodsWe searched The Cochrane Library, Web of Science, PubMed, EMbase, Ovid, EBSCO, CBM, CNKI, VIP and WanFang Data from inception to Jan. 2015, to collect randomized controlled trials (RCTs) and quasi-RCTs about early moxibustion therapy on the recovery of gastrointestinal functioning. Two reviewer independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was conducted using RevMan 5.3 and Stata 12.0 softwares. ResultsA total of nine RCTs and four quasi-RCTs involving 1444 patients were included. The results of meta-analysis indicated that, the early moxibustion therapy group was significantly superior to the control group in total effective rate (OR=1.26, 95%CI 1.17 to 1.36, P<0.00001), the time to first bowel motion (MD=-11.79, 95%CI -13.79 to -9.78, P<0.00001), the time to first flatus (MD=-15.13, 95%CI -17.40 to -12.85, P<0.00001) and the time to first passage of feces (MD=-34.93, 95%CI -59.33 to -10.53, P=0.005). ConclusionCurrent evidence shows that early moxibustion therapy after gastrointestinal surgery is beneficial for promoting the recovery of gastrointestinal functioning. In addition, due to the low methodological quality of included studies, larger sample, high-quality RCTs are needed to prove the above conclusion.
ObjectiveTo systematically review the efficacy of Chinese herbal enema in ileus patients. MethodsThe 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. ResultsA 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. ConclusionChinese 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.