治疗刺激性肠综合征:随机对照试验的系统审查和元分析
Omar Saab1, Hasan Al-Obaidi2, Marwah Algodi3
1University of Texas Health Sciences Center at Houston; Department of Medicine, Houston, TX.
似乎没有显著缓解刺激性肠综合征 (IBS),焦虑或抑郁症的症状. 需要进一步的高质量研究来证实这些发现,并将作为可行的IBS治疗方法.
科学领域:
- 胃肠病学 胃肠病学
- 综合医学是一个整体的医学.
- 临床研究 临床研究
背景情况:
- 刺激性肠综合征 (IBS) 是一种普遍存在的胃肠疾病,影响全球人口的10-20%.
- 关于对IBS症状的疗效的现有研究提出了不一致的发现.
- 综合现有证据需要进行全面的审查.
研究的目的:
- 系统地审查和元分析随机对照试验 (RCT),评估对IBS症状的影响.
- 评估对胃肠道症状严重程度,焦虑,抑郁和IBS患者的生活质量的影响.
主要方法:
- 在PubMed,EMBASE,WOS,SCOPUS和Cochrane的系统文献搜索到2024年10月.
- 使用标准化平均差异 (SMD) 和95%置信区间 (CI) 的连续变量的元分析.
- 使用奇二测试和I2统计数据进行评估的异质性;PROSPERO ID:CRD42024611633.
主要成果:
- 包括11个涉及535名患者 (成人和青少年) 的RCT.
- 与对照组相比,在降低胃肠道症状严重程度方面没有统计学上显著的差异 (SMD -0.66,P=0.12).
- 在焦虑 (SMD -0.39,P=0.09),抑郁 (SMD -0.46,P=0.19) 或生活质量 (SMD 0.53,P=0.25) 方面没有观察到显著改善.
结论:
- 目前的证据表明,并不能有效地减少IBS症状严重程度,焦虑或抑郁,也不能改善生活质量.
- 高度的方法异质性和包含在RCT中的偏差风险限制了最终的结论.
- 在等待进一步的大规模,高质量的RCT之前,不能建议用于IBS治疗.
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