Calcium Channel Blockers for Irritable Bowel Syndrome: Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

ZHAO Pengcheng , WANG Yiping , PAN Tao

Digestic Department of West China Hospital of Sichuan University; Chengdu 610041; China;

Corresponding author：

Keywords：

Calcium chanel blockers; Irritable bowel syndrome; Efficacy; Systematic review

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Objective 　To provide best available evidence for clinical practice and further research planning on IBS treatment, we reviewed systematically all the randomised controlled trials on calcium channel blockers for irritable bowel syndrome. The primary objective was to determine whether there was enough evidence that calcium channel blocker was effective and safe in the treatment of patients with IBS.
Method 　Searches were performed in Trials Register of the Cochrane Complementary Medicine Field, data from the pharmaceutical company were also retrieved. In addition we searched the electronic bibliographic databases: Cochrane Controlled Trials Register, Medline, Embase, Chinese Biological Medical Database (CBM-disc). We handsearched some important Chinese journals. Two reviewers included studies, assessed the quality of studies and extracted data independently. Disagreement was resolved by discussion or the third party when needed. The following primary outcomes were assessed: ① Effective rate at the end of experiment, ② Improvmemnt in abodeminal pain and distention, ③ Adverse events.
Results 　49 potentially eligible trials were identified, of which 9 trials (831 patients) were included. 8 trials were waiting for assessment. The mean percentage of patients with global improvement was 48.9% in control group and 75% in the calcium channel blockers group. In favour of calcium group with a mean OR 4.54, 95%CI (2.38, 8.66).
Conclusions 　Selective calcium channel blockers might be effective and safe in the treatment of patients with IBS.Because the methodological quality of all included studies was poor,further high-quality randomised controlled trials should be performed.

Citation： ZHAO Pengcheng,WANG Yiping,PAN Tao. Calcium Channel Blockers for Irritable Bowel Syndrome: Systematic Review. Chinese Journal of Evidence-Based Medicine, 2004, 04(3): 167-172. doi: Copy

1.	［1］Wang WA, Pan GZh, Qian JM. Connitive therapy in the treatrnent of irritable bowel syndrome [ J ]. Chinese Journal of Gastroenterology and Hepatology, 2000 ;9 (2) :85.
2.	王伟岸,潘国宗,钱家鸣.肠易激综合征的认知治疗[J].胃肠病学和肝病学杂志,2000;9(2):85.
3.	［2］Manning AP, Thompson WG, Heaton KW, Morris AF. Towards positive diagnosis of the irritable bowel syndromr [J].Br Med J,1978;2(6 138) :653-654.
4.	［3］Thompson WG, Greed F, Drossman DA, et al. Functional Bowel disease and functional abdominal pain[J]. Gastroenterol Int, 1992 ;5 ( 1 ) :75-91.
5.	［4］Drossman DA;Corazziari E;Talley NJ;Thompson WG;Whiteeaf. The Functional Gastrointestinal Disorders. In:Thompson, Longstreth G, eds. c. Functional Bowel Disorders.and Difunctional Abdminal Pain. Virginia[J]. degnon, 2000:355-375.
6.	［5］Anon. Clinical criteria ofirritable bowel syndromein study[J].Chin J Digestion, 1987;7:cover 3.
7.	佚名,肠易激综合征科研病例选择标准[J].中华消化杂志,1987;7:封3.
8.	［6］Clarke M, Oxman AD, editors. Cochrane Reviewer’s Handbook 4.1 [ updated June 2000 ]. In: ReviewManager (RevMan)[ Computerprogram ]. Version4. 1. Oxford, England: The Cochrane Collaboration,2000.
9.	［7］Wang DB, Chui MH, Tao X, Shun XL. Clinical Analysis of Pinaverium bromidein the treatment of irritable bowel syndrome[J]. Jiang Su pharmcacy and clinical study, 2000; 8(4) :27-28.
10.	王德标,崔美华,陶莘,孙祥龙.匹维溴铵治疗肠易激综合征临床分析[J].江苏药学与l临床研究,2000;8(4):27-28.
11.	［8］Battaglia G, Morselli-Labate AM, Camarri E, et al: Otilonium bromide in irritable bowel syndrome: a double-blind, placeocontrolled, 15-week study[J]. Aliment Pharmacolther, 1998;12(10) :1 003-1 010.
12.	［9］Baldi F, Corinaldesi R, Ferrarini F, et al. Clinical and functional evaluation of octilonium bromide in the treatment of irritable bowel syndrome :A double blind controlled trial[J]. Clin Trials j, 1983 ;20:77-88.
13.	［10］Awad R, Dibildox M, Ortiz F. Irritable bowel syndrome treatment using observation on the efficacy of as a calcium channel blocker. A randomized double-blind placebo-controlled trial[J]. Acta Gastroenterol Latinoarn ,1995 ;25 ( 3 ) :137-144.
14.	［11］Levy C, Charbonnier A, Cachin M. Pinaverium bromide and functional disease ( double blind study) [ J ]. Sem Hop Ther,1977 ;53(7-8) :372-4.
15.	［12］DelmontJ. Intsret de 1 ’ adjonction d ’ un antispasmodique musculotrope autraitement des constipations douloureuses des colopathies fonctionnelles par le son. Med Chit Dig, 1981; 4:365-370.
16.	［13］Qu ChY, You HN,Zhang 1, Jiang JH, Li DG. Observation on the efficacy of Pinaverium bromidein in the treatment of irritable bowel syndrome[J]. Chinese Journal of Clinical Pharmacy, 2000:9(3) :180-181.
17.	瞿春莹,尤汉宁,章莉,蒋靖寰,李定国.匹维溴铵治疗肠易激综合征的疗效观察[J].中国临床药学杂志,2000;9(3):180-181.
18.	［14］Gu JH, Zhong NH. Pinaverium bromide associated with miyaBM in the treatment of irritable bowel syndrome in 56 cases[J]. Journal of BengBu Medical College, 2001 ;26(2 ): 157.
19.	谷金华,钟能华.匹维溴铵、米雅-BM联用治疗肠易激综合征56例[J].蚌埠医学院学报,2001;26(2);157.
20.	［15］HuangYM, ZhuangSHX, LOUB, NiYZhangYG. Clinical observation on the efficacy of octilonium bromide in the treatment of irritable bowel syndrome [J ]. Chinese Journal of Gastroenterology and Hepatology , 2001 ;10(2) :192-193.
21.	黄咏梅,张淑秀,娄蓓,倪莹,张运贵.奥替溴铵治疗肠易激综合征短期疗效观察[J].胃肠病学和肝病学杂志,200l;10(2):192-193.
22.	［16］Cooper HI. Irritable bowel syndrome: Diagnosis by exclusion[J]. Geriatrics, 1980;35:43-6.
23.	［17］Spiller RC:Problems and challenges in the design of irritable bowel syndrome clinical trisals:experience from published trials[J]. Am J Med, 1999;107(5A):91s-97s.

1. ［1］Wang WA, Pan GZh, Qian JM. Connitive therapy in the treatrnent of irritable bowel syndrome [ J ]. Chinese Journal of Gastroenterology and Hepatology, 2000 ;9 (2) :85.
2. 王伟岸,潘国宗,钱家鸣.肠易激综合征的认知治疗[J].胃肠病学和肝病学杂志,2000;9(2):85.
3. ［2］Manning AP, Thompson WG, Heaton KW, Morris AF. Towards positive diagnosis of the irritable bowel syndromr [J].Br Med J,1978;2(6 138) :653-654.
4. ［3］Thompson WG, Greed F, Drossman DA, et al. Functional Bowel disease and functional abdominal pain[J]. Gastroenterol Int, 1992 ;5 ( 1 ) :75-91.
5. ［4］Drossman DA;Corazziari E;Talley NJ;Thompson WG;Whiteeaf. The Functional Gastrointestinal Disorders. In:Thompson, Longstreth G, eds. c. Functional Bowel Disorders.and Difunctional Abdminal Pain. Virginia[J]. degnon, 2000:355-375.
6. ［5］Anon. Clinical criteria ofirritable bowel syndromein study[J].Chin J Digestion, 1987;7:cover 3.
7. 佚名,肠易激综合征科研病例选择标准[J].中华消化杂志,1987;7:封3.
8. ［6］Clarke M, Oxman AD, editors. Cochrane Reviewer’s Handbook 4.1 [ updated June 2000 ]. In: ReviewManager (RevMan)[ Computerprogram ]. Version4. 1. Oxford, England: The Cochrane Collaboration,2000.
9. ［7］Wang DB, Chui MH, Tao X, Shun XL. Clinical Analysis of Pinaverium bromidein the treatment of irritable bowel syndrome[J]. Jiang Su pharmcacy and clinical study, 2000; 8(4) :27-28.
10. 王德标,崔美华,陶莘,孙祥龙.匹维溴铵治疗肠易激综合征临床分析[J].江苏药学与l临床研究,2000;8(4):27-28.
11. ［8］Battaglia G, Morselli-Labate AM, Camarri E, et al: Otilonium bromide in irritable bowel syndrome: a double-blind, placeocontrolled, 15-week study[J]. Aliment Pharmacolther, 1998;12(10) :1 003-1 010.
12. ［9］Baldi F, Corinaldesi R, Ferrarini F, et al. Clinical and functional evaluation of octilonium bromide in the treatment of irritable bowel syndrome :A double blind controlled trial[J]. Clin Trials j, 1983 ;20:77-88.
13. ［10］Awad R, Dibildox M, Ortiz F. Irritable bowel syndrome treatment using observation on the efficacy of as a calcium channel blocker. A randomized double-blind placebo-controlled trial[J]. Acta Gastroenterol Latinoarn ,1995 ;25 ( 3 ) :137-144.
14. ［11］Levy C, Charbonnier A, Cachin M. Pinaverium bromide and functional disease ( double blind study) [ J ]. Sem Hop Ther,1977 ;53(7-8) :372-4.
15. ［12］DelmontJ. Intsret de 1 ’ adjonction d ’ un antispasmodique musculotrope autraitement des constipations douloureuses des colopathies fonctionnelles par le son. Med Chit Dig, 1981; 4:365-370.
16. ［13］Qu ChY, You HN,Zhang 1, Jiang JH, Li DG. Observation on the efficacy of Pinaverium bromidein in the treatment of irritable bowel syndrome[J]. Chinese Journal of Clinical Pharmacy, 2000:9(3) :180-181.
17. 瞿春莹,尤汉宁,章莉,蒋靖寰,李定国.匹维溴铵治疗肠易激综合征的疗效观察[J].中国临床药学杂志,2000;9(3):180-181.
18. ［14］Gu JH, Zhong NH. Pinaverium bromide associated with miyaBM in the treatment of irritable bowel syndrome in 56 cases[J]. Journal of BengBu Medical College, 2001 ;26(2 ): 157.
19. 谷金华,钟能华.匹维溴铵、米雅-BM联用治疗肠易激综合征56例[J].蚌埠医学院学报,2001;26(2);157.
20. ［15］HuangYM, ZhuangSHX, LOUB, NiYZhangYG. Clinical observation on the efficacy of octilonium bromide in the treatment of irritable bowel syndrome [J ]. Chinese Journal of Gastroenterology and Hepatology , 2001 ;10(2) :192-193.
21. 黄咏梅,张淑秀,娄蓓,倪莹,张运贵.奥替溴铵治疗肠易激综合征短期疗效观察[J].胃肠病学和肝病学杂志,200l;10(2):192-193.
22. ［16］Cooper HI. Irritable bowel syndrome: Diagnosis by exclusion[J]. Geriatrics, 1980;35:43-6.
23. ［17］Spiller RC:Problems and challenges in the design of irritable bowel syndrome clinical trisals:experience from published trials[J]. Am J Med, 1999;107(5A):91s-97s.

Chinese Journal of Evidence-Based Medicine

Calcium Channel Blockers for Irritable Bowel Syndrome: Systematic Review

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