Potential Benefit With Complementary and Alternative Medicine in Irritable Bowel Syndrome: A Systematic Review and Meta-analysis.
Potential Benefit With Complementary and Alternative Medicine in Irritable Bowel Syndrome: A Systematic Review and Meta-analysis.
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DOI：
10.1016/j.cgh.2020.09.035
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发表时间：
2021-08
期刊：
影响因子：
--
通讯作者：
Shin A
中科院分区：
文献类型：
--
作者：
Billings W;Mathur K;Craven HJ;Xu H;Shin A
肠易激综合征(IBS)患者可以寻求补充和替代医学(CAM)。我们进行了一项全面的系统回顾和荟萃分析，检验了成人肠易激综合征患者服用CAM与安慰剂或Sham的疗效。在出版物数据库中搜索成人IBS患者的CAM疗法(草药疗法、膳食补充剂、心身疗法、身体疗法和能量疗法)的随机对照试验。提取数据以获得腹痛平均改善(标准化平均差异[SMD])和使用随机效应模型的总体反应的相对风险(RR)的合并估计。完成了敏感度和亚组分析以及质量评估。在鉴定出的2825篇文章中，有66篇纳入其中。草药疗法(SMD=0.47，95%CI：0.20至0.75，I2=82%)显示出显著优于安慰剂的腹痛疗效(对估计的置信度较低)。心身结合疗法对腹痛的益处具有边缘意义(−=0.2 9，95%CI：0.0 1~0.5 9，I2=78%)。与安慰剂相比，草药疗法(RR=1.57，95%CI：1.31~1.88，I2=77%)、膳食补充剂(RR=1.95，95%CI：1.02~3.73，I2=75%)和心身疗法(RR=1.67，95%CI：1.13~2.49，I2=63%)显示出与安慰剂(估计置信度较低)相比，总体疗效更好。与安慰剂或Sham相比，基于身体和能量的治疗方法在腹痛或总体反应方面没有明显的好处。CAM疗法，如草药或膳食补充剂，以及以身心为基础的方法，可能对IBS的腹痛和总体反应有利。然而，证据的总体质量是低的。严格、高质量的临床试验是研究肠易激综合征患者CAM的必要保证。
Patients with irritable bowel syndrome (IBS) may pursue complementary and alternative medicine (CAM). We conducted a comprehensive systematic review and meta-analysis examining efficacy of CAM vs. placebo or sham in adults with IBS. Publication databases were searched for randomized controlled trials of CAM therapies (herbal therapy, dietary supplements, mind-body based, body-based, and energy-healing) in adults with IBS. Data were extracted to obtain pooled estimates of mean improvement in abdominal pain (standardized mean difference [SMD]) and relative risk (RR) of overall response using random effects models. Sensitivity and subgroup analyses along with quality assessments were completed. Among 2825 articles identified, 66 were included. Herbal therapy (SMD=0.47, 95% CI: 0.20 to 0.75, I2=82%) demonstrated significant benefit over placebo for abdominal pain (low confidence in estimates). Benefit with mind-body based therapy for abdominal pain was of borderline significance (SMD=0.29, 95% CI: −0.01 to 0.59, I2=78%). Herbal therapy (RR=1.57, 95% CI: 1.31 to 1.88, I2=77%), dietary supplements (RR=1.95, 95% CI: 1.02 to 3.73, I2=75%), and mind-body based therapy (RR=1.67, 95% CI: 1.13 to 2.49, I2=63%) showed benefit for overall response compared to placebo (low confidence in estimates). Body-based and energy healing therapies demonstrated no significant benefit over placebo or sham for abdominal pain or overall response. CAM therapies such as herbal or dietary supplements and mind-body based approaches may be beneficial for abdominal pain and overall response in IBS. However, overall quality of evidence is low. Rigorous, high quality clinical trials are warranted to investigate CAM in IBS.
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影响因子：
29.4
作者：
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DOI：
10.1038/ajg.2011.184
发表时间：
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期刊：
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