Efficacy of Chinese Herbal Medicines in Treating Chronic Functional Constipation: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

MA Jizheng ¹ ,  LIU Shaoneng ¹ , WU Taixiang ² , SHIlei ¹

1. Department of Gastroenterology, Guang’an Men Hospital Affiliated to China Academy of Chinese Medical Science, Beijing 100053, China;2. Chinese Cochrane Center, Chinese EBM Center, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

LIU Shaoneng, Email: liushaoneng886@yahoo.com.cn

Keywords：

Functional constipation; Traditional Chinese Medicine; Chinese herbal medicine; Randomized controlled trial; Systematic review; Meta-analysis

DOI：

10.7507/1672-2531.20100572

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective 　To assess the efficacy and safety of Chinese herbal medicines for chronic functional constipation.
Methods 　We searched CNKI (1989 to November, 2009), CBM (1989 to November, 2009), VIP (1989 to November, 2009), Cochrane Library (Issue 4, 2009), PubMed (1966 to November, 2009) and EMbase (1986 to November, 2009). All randomized and quasi-randomized clinical trials of treating chronic functional constipation with Chinese herbal medicines versus untreated, placebo or western drug groups were included. Data were extracted independently by two reviewers. The methodological quality of trials was evaluated with Cochrane Handbook 5.0.2 criteria. Meta-analyses were conducted by the RevMan 5.0 software.
Results 　Twenty-one trials involving 2 602 patients were included. The Meta-analysis results showed that: Chinese herbal medicines improved both syndromes and colonic transit function of recipients; moreover, it is superior to both gastrointestinal prokinetic agent in effective rate (RR=1.18, 95%CI 1.12 to 1.25), healing rate (RR=1.59, 95%CI 1.35 to 1.88), and cathartic in effective rate (RR=1.18, 95%CI 1.10 to 1.27), healing rate (RR=1.16, 95%CI 1.29 to 2.10). Integration of Chinese herbal medicines and gastrointestinal prokinetic agent is superior to gastrointestinal prokinetic agent in effective rate (RR=1.21 95%CI 1.09 to 1.34) and healing rate (RR=1.41, 95%CI 1.11 to 1.79).
Conclusion 　Some Chinese herbal medicines may be effective and safe in treating chronic functional constipation, which can not be bly proved at present for lack of studies with high quality.

Citation： MA Jizheng,LIU Shaoneng,WU Taixiang,SHIlei. Efficacy of Chinese Herbal Medicines in Treating Chronic Functional Constipation: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2010, 10(10): 1213-1221. doi: 10.7507/1672-2531.20100572 Copy

1.	于普林, 李增金, 郑宏, 等. 老年便秘流行病学特点的初步分析. 中华老年医学杂志, 2001, 20(2): 132-134.
2.	郭晓峰, 柯美云, 潘国宗, 等. 北京地区成人慢性便秘整群、分层、随机流行病学调查及其相关因素分析. 中华消化杂志, 2002, 22(10): 637-638.
3.	Peppas G, Alexiou VG, Mourtzoukou E, et al. Epidemiology of constipation in Europe and Oceania: a systematic review. BMC Gastroenterol, 2008, 8(5): 1-7.
4.	Kenny KA, Skelly JM. Dietary fiber for constipation in older adults:a systematic review. Clinical Effectiveness in Nursing, 2001, (5): 120-128.
5.	吴佳煖, 刘晓红, 刘巍, 等. 慢性便秘患者精神心理状况及生活质量调查-多中心临床调查. 中华实用内可杂志, 2009, 29(3): 237-239.
6.	Dennison C, Prasad M, Lloyd A, et al. The health-related quality of life and economic burden of constipation. Pharmacoeconomics, 2005, 23(5): 461-476.
7.	Rantis PC, Vernava AM, Daniel GL, et al. Chronic constipation–is the work-up worth the cost? Dis Colon Rectum, 1997, 40: 280-286.
8.	Pekmezaris R, Aversa L, Wolf-Klein G, et al. The cost of chronic constipation. JAMDA, 2002, 8: 224-228.
9.	Johanson JF. Review of the Treatment Options for Chronic Constipation. MedGenMe-d, 2007; 9(2): 25. Availate from: URL: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1994829/.
10.	Chen LC, Wang BR, Chou YC, et al. Drug utilization pattern of Chinese herbal medicines in a general hospital in Taiwan. Pharmacoepidemiology and Drug Safety, 2005, 14: 651-657.
11.	Lewith G. Complementary Medicine Research Unit. Ecam, 2005, 2(3): 399-407.
12.	郑雪平, 许芝银, 丁义江. 白术治疗结肠慢传输型便秘的临床研究. 南京中医药大学博士学位论文, 2004, 1-49.
13.	张虹玺, 田振国. 养荣润肠舒合剂治疗结肠慢传输型便秘的临床研究. 辽宁中医学院硕士学位论文, 2004, 1-33.
14.	剑锋, 李国栋. 养血润肠方治疗血虚型慢性功能性便秘的临床研究. 中国中医科学院博士学位论文, 2006, 1-127.
15.	殷克, 田振国. 扶正润肠舒颗粒治疗便秘110例临床观察. 辽宁中医学院硕士学位论文, 2003, 1-25.
16.	石冲, 周建华. 六君子汤合增液汤加减治疗功能性便秘(气阴亏虚证)的临床研. 长春中医药大学硕士学位论文, 2008, 1-34.
17.	藏小华, 刘仍海. 中药敷脐法治疗脾虚气滞型便秘的临床总结. 北京中医药大学硕士学位论文, 2008, 1-36.
18.	刘德武. 济川煎合五仁丸加减治疗老年性便秘30例报告. 贵阳中医学院学报, 2008, 30(4): 37-38.
19.	郭敏, 王爱华. 滋阴理肠方治疗老年慢传输型便秘36例总结. 湖南中医杂志, 2008, 24(3): 25-27.
20.	赵云燕, 谢炜, 陈宝田, 等. 便必清对虚证便秘患者结肠传输时间的影响. 中国中西医结合杂志, 2003, 23(11): 862-863.
21.	董恒, 高玉中. 益气润肠汤治疗慢传输型便秘60例. 江西中医药, 2009, 40(320): 30-31.
22.	马相斌. 益气活血法治疗功能性便秘. 光明中医, 2009, 24(4): 1710.
23.	孙贺营. 小巧验方便秘丸治疗习惯性便秘80例. 中医研究, 2009, 22(1): 36-37.
24.	孙建华. 温脾润肠汤治疗慢传输性便秘100例. 上海中医药杂志, 2007, 41(9): 44-45.
25.	李纪强, 罗仁, 葛鑫宇, 等. 加味枳术汤治疗功能性便秘的临床研究. 安徽中医学院学报, 2009, 28(3): 9-11.
26.	谈燕清, 胡运莲. 厚枳三仁汤治疗慢性功能性便秘(气秘兼湿热证)的临床研究. 湖北中医学院硕士学位论文, 2009, 1-50.
27.	张学海, 任东林. 大肠水疗合丹参粉针剂保留灌肠治疗功能性便秘的临床研究. 广州中医药大学硕士学位论文, 2005, 1-50.
28.	陈中和, 曾二妹. 补中益气丸加西沙比利治疗老年功能性便秘68例. 中国中西医结合消化杂志, 2004, 12(4): 243-244.
29.	石玲. 中西医结合治疗习惯性便秘43例临床观察. 浙江中医杂志, 2008, 43(9): 532-533.
30.	王文辉. 中西医结合治疗老年便秘62例临床观察. 深圳中西医结合杂志, 2007, 17(4): 244-246.
31.	刘利华, 彭澎. 益气养阴法合西药治疗慢传输型便秘临床研究. 辽宁中医药大学学报, 2008, 10(1): 86-87.
32.	金朝辉, 段建华, 赵洪川, 等. 功能性便秘患者结肠通过时间及四逆散干预的临床研究. 中国中西医结合杂志, 2006, 26(10): 896-898.
33.	黄煌. 论方证相应说及其意义. 中国中医基础医学杂志, 1998, 4(6): 11-13.
34.	王泓午, 王阶, 衷敬柏, 等. 对中医学证候中经验和规律的一种思考. 天津中医药, 2006, 23(3): 225-226.
35.	Longstereth GF, Thompson WG, Chey WD, et al. Gastroenterology, 2006, 130: 1480-1491.
36.	Cash BD, Lacy BE. Systematic Review: FDA-Approved Priscription Medications for Adults With Constipation. Gastroenterology & Hepatology, 2006, 2(10), 736-749.
37.	Koh CE, Young CJ, Solomn MJ, et al. Syetematic review of randomized controlled trials of the effectiveness of biofeedback for pelvic floor dysfunction. Br J Surg, 2008, 95: 1079-1087.
38.	Medsafe Website. Cisapride and Arrhythmias. Availate from: URL: http://www.medsafe.govt.nz/profs/PUarticles/cisapride.htm.
39.	Medpage today. Heart Risk Prompts FDA to Pull IBS Agent Tegaserod (Zelnorm) Availate from: URL: http://www.medpagetoday.com/Gastroenterology/IrritableBowelSyndrome/5366.
40.	新京报. 北京公立中医院首推绩效考核视特色服务质量拨款. 来源网址:http://health.people.com.cn/GB/10063135.html.
41.	Rajagopal S. The placebo effect. Psychiatric Bulletin, 2006, 30: 185-188.
42.	胡品津, 刘新光, 主编. 消化内科学. 人民卫生出版社, 北京, 2008: 115.
43.	张宏, 彭成, 余成浩, 等. 附子煎煮时间、给药剂量与温阳功效的相关性研究. 中国中药杂志, 2007, 32(20): 2118-2123.
44.	段碧芳, 刘建平. 中医人文特征与循证医学评价方法. 中医杂志，2007, 48(4): 314-136.

1. 于普林, 李增金, 郑宏, 等. 老年便秘流行病学特点的初步分析. 中华老年医学杂志, 2001, 20(2): 132-134.
2. 郭晓峰, 柯美云, 潘国宗, 等. 北京地区成人慢性便秘整群、分层、随机流行病学调查及其相关因素分析. 中华消化杂志, 2002, 22(10): 637-638.
3. Peppas G, Alexiou VG, Mourtzoukou E, et al. Epidemiology of constipation in Europe and Oceania: a systematic review. BMC Gastroenterol, 2008, 8(5): 1-7.
4. Kenny KA, Skelly JM. Dietary fiber for constipation in older adults:a systematic review. Clinical Effectiveness in Nursing, 2001, (5): 120-128.
5. 吴佳煖, 刘晓红, 刘巍, 等. 慢性便秘患者精神心理状况及生活质量调查-多中心临床调查. 中华实用内可杂志, 2009, 29(3): 237-239.
6. Dennison C, Prasad M, Lloyd A, et al. The health-related quality of life and economic burden of constipation. Pharmacoeconomics, 2005, 23(5): 461-476.
7. Rantis PC, Vernava AM, Daniel GL, et al. Chronic constipation–is the work-up worth the cost? Dis Colon Rectum, 1997, 40: 280-286.
8. Pekmezaris R, Aversa L, Wolf-Klein G, et al. The cost of chronic constipation. JAMDA, 2002, 8: 224-228.
9. Johanson JF. Review of the Treatment Options for Chronic Constipation. MedGenMe-d, 2007; 9(2): 25. Availate from: URL: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1994829/.
10. Chen LC, Wang BR, Chou YC, et al. Drug utilization pattern of Chinese herbal medicines in a general hospital in Taiwan. Pharmacoepidemiology and Drug Safety, 2005, 14: 651-657.
11. Lewith G. Complementary Medicine Research Unit. Ecam, 2005, 2(3): 399-407.
12. 郑雪平, 许芝银, 丁义江. 白术治疗结肠慢传输型便秘的临床研究. 南京中医药大学博士学位论文, 2004, 1-49.
13. 张虹玺, 田振国. 养荣润肠舒合剂治疗结肠慢传输型便秘的临床研究. 辽宁中医学院硕士学位论文, 2004, 1-33.
14. 剑锋, 李国栋. 养血润肠方治疗血虚型慢性功能性便秘的临床研究. 中国中医科学院博士学位论文, 2006, 1-127.
15. 殷克, 田振国. 扶正润肠舒颗粒治疗便秘110例临床观察. 辽宁中医学院硕士学位论文, 2003, 1-25.
16. 石冲, 周建华. 六君子汤合增液汤加减治疗功能性便秘(气阴亏虚证)的临床研. 长春中医药大学硕士学位论文, 2008, 1-34.
17. 藏小华, 刘仍海. 中药敷脐法治疗脾虚气滞型便秘的临床总结. 北京中医药大学硕士学位论文, 2008, 1-36.
18. 刘德武. 济川煎合五仁丸加减治疗老年性便秘30例报告. 贵阳中医学院学报, 2008, 30(4): 37-38.
19. 郭敏, 王爱华. 滋阴理肠方治疗老年慢传输型便秘36例总结. 湖南中医杂志, 2008, 24(3): 25-27.
20. 赵云燕, 谢炜, 陈宝田, 等. 便必清对虚证便秘患者结肠传输时间的影响. 中国中西医结合杂志, 2003, 23(11): 862-863.
21. 董恒, 高玉中. 益气润肠汤治疗慢传输型便秘60例. 江西中医药, 2009, 40(320): 30-31.
22. 马相斌. 益气活血法治疗功能性便秘. 光明中医, 2009, 24(4): 1710.
23. 孙贺营. 小巧验方便秘丸治疗习惯性便秘80例. 中医研究, 2009, 22(1): 36-37.
24. 孙建华. 温脾润肠汤治疗慢传输性便秘100例. 上海中医药杂志, 2007, 41(9): 44-45.
25. 李纪强, 罗仁, 葛鑫宇, 等. 加味枳术汤治疗功能性便秘的临床研究. 安徽中医学院学报, 2009, 28(3): 9-11.
26. 谈燕清, 胡运莲. 厚枳三仁汤治疗慢性功能性便秘(气秘兼湿热证)的临床研究. 湖北中医学院硕士学位论文, 2009, 1-50.
27. 张学海, 任东林. 大肠水疗合丹参粉针剂保留灌肠治疗功能性便秘的临床研究. 广州中医药大学硕士学位论文, 2005, 1-50.
28. 陈中和, 曾二妹. 补中益气丸加西沙比利治疗老年功能性便秘68例. 中国中西医结合消化杂志, 2004, 12(4): 243-244.
29. 石玲. 中西医结合治疗习惯性便秘43例临床观察. 浙江中医杂志, 2008, 43(9): 532-533.
30. 王文辉. 中西医结合治疗老年便秘62例临床观察. 深圳中西医结合杂志, 2007, 17(4): 244-246.
31. 刘利华, 彭澎. 益气养阴法合西药治疗慢传输型便秘临床研究. 辽宁中医药大学学报, 2008, 10(1): 86-87.
32. 金朝辉, 段建华, 赵洪川, 等. 功能性便秘患者结肠通过时间及四逆散干预的临床研究. 中国中西医结合杂志, 2006, 26(10): 896-898.
33. 黄煌. 论方证相应说及其意义. 中国中医基础医学杂志, 1998, 4(6): 11-13.
34. 王泓午, 王阶, 衷敬柏, 等. 对中医学证候中经验和规律的一种思考. 天津中医药, 2006, 23(3): 225-226.
35. Longstereth GF, Thompson WG, Chey WD, et al. Gastroenterology, 2006, 130: 1480-1491.
36. Cash BD, Lacy BE. Systematic Review: FDA-Approved Priscription Medications for Adults With Constipation. Gastroenterology & Hepatology, 2006, 2(10), 736-749.
37. Koh CE, Young CJ, Solomn MJ, et al. Syetematic review of randomized controlled trials of the effectiveness of biofeedback for pelvic floor dysfunction. Br J Surg, 2008, 95: 1079-1087.
38. Medsafe Website. Cisapride and Arrhythmias. Availate from: URL: http://www.medsafe.govt.nz/profs/PUarticles/cisapride.htm.
39. Medpage today. Heart Risk Prompts FDA to Pull IBS Agent Tegaserod (Zelnorm) Availate from: URL: http://www.medpagetoday.com/Gastroenterology/IrritableBowelSyndrome/5366.
40. 新京报. 北京公立中医院首推绩效考核视特色服务质量拨款. 来源网址:http://health.people.com.cn/GB/10063135.html.
41. Rajagopal S. The placebo effect. Psychiatric Bulletin, 2006, 30: 185-188.
42. 胡品津, 刘新光, 主编. 消化内科学. 人民卫生出版社, 北京, 2008: 115.
43. 张宏, 彭成, 余成浩, 等. 附子煎煮时间、给药剂量与温阳功效的相关性研究. 中国中药杂志, 2007, 32(20): 2118-2123.
44. 段碧芳, 刘建平. 中医人文特征与循证医学评价方法. 中医杂志，2007, 48(4): 314-136.

Chinese Journal of Evidence-Based Medicine

Efficacy of Chinese Herbal Medicines in Treating Chronic Functional Constipation: A Systematic Review

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