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 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.