治疗儿童难治性便秘的方法
Morris Gordon1, Ciaran Grafton-Clarke2,3, Shaman Rajindrajith4
1School of Medicine, University of Central Lancashire, Preston, UK.
The Cochrane database of systematic reviews
|June 19, 2024
概括
治疗儿童难治性便秘的疗法显示出有限的疗效. 大多数干预措施的证据的确定性非常低,一些中度证据表明 lubiprostone 或 prucalopride 与安慰剂之间差异很小.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 临床药理学 临床药理学
- 基于证据的医学 基于证据的医学
背景情况:
- 可吸收性便秘,长期便秘不响应常规治疗,在儿童中构成治疗挑战.
- 它对生活质量和卫生系统产生重大影响,需要有效和安全的干预措施.
研究的目的:
- 评估儿童 (0-18岁) 难治便秘的各种治疗方法的疗效和安全性.
主要方法:
- 随机对照试验 (RCT) 的系统审查,将药物,非药物或外科治疗与安慰剂或活性对照剂进行比较.
- 搜索了多个数据库直到2023年6月,包括CENTRAL,MEDLINE和Embase.
- 评估的主要结局:使用GRADE标准解决症状,排便频率,治疗成功和不良事件.
主要成果:
- 包括10个RCT (1278名儿童). 由于存在偏见和不准确性的风险,大多数比较的证据确定性非常低.
- 低至中等确定性证据表明,与安慰剂相比,口服 lubiprostone 和口服 prucalopride 可能在治疗成功和不良事件中几乎没有差异.
- 对肉毒素A注射,阴囊和生物反治疗的数据非常不确定.
结论:
- 关于治疗儿科难治性便秘的疗效和安全性的强有力的结论是有限的,因为大多数干预措施的确定性证据非常低.
- 需要进一步进行高质量的RCT,以确定有效和安全的治疗选择.
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