中医外治法治疗便秘证据图谱分析
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R256.35;R244

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广东省中医药局科研项目(20241109);广东省基础与应用基础研究基金面上项目(2023A1515220029)


Evidence Mapping Analysis of External Therapies of Traditional Chinese Medicine for Constipation
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    摘要:

    目的:对中医外治法治疗便秘的系统评价/meta分析文献进行系统分析,为后续研究的开展提供参考依据。方法:检索中国知网(CNKI)、万方数据库(WanFang)、维普数据库(VIP)、中国生物医学文献数据库(CBM) 以及PubMed、The Cochrane Library、Web of Science、Embase等中英文数据库中中医外治法治疗便秘的系统评价与meta分析文献,检索时间为建库起至2025年8月。使用AMSTAR 2工具评价纳入研究的方法学质量;依据《护理结局分类》对结局指标进行归类;通过Excel 完成数据提取、整理与编码,并使用SPSS27.0统计学软件以气泡图形式对证据内容进行可视化呈现。结果:最终纳入68篇系统评价/meta分析文献,主要涉及功能性便秘、未特指的慢性便秘、阿片类药物相关性便秘、化疗相关性便秘、脑卒中相关性便秘、婴幼儿/儿童便秘以及其他类型便秘,其中涉及到功能性便秘的研究最多,有16篇,占23.53%。涉及的干预措施有针刺疗法、穴位疗法、耳穴疗法、推拿按摩、灸法以及其他中医外治法,其中针刺疗法的研究最多,有23 篇,占33.82%。主要的结局指标包括有效率、痊愈率、排便困难评分、粪便性状评分等12类,在有效率这一结局指标中,有48篇文献的研究结论为“有益”。高质量证据5篇,仅占7.35%。结论:中医外治法治疗便秘具有一定疗效;不同中医外治法的干预效果存在差异,在不同人群中的应用效果也大相径庭,大部分研究缺少不良反应的结局报告;未来仍需开展实验设计严谨、结局报告规范的临床研究,为指南、专家共识等行业标准的制定提供高质量的证据。

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    Abstract: Objective: To systematically analyze the systematic reviews/meta-analyses on external therapies of traditional Chinese medicine for constipation, so as to provide reference for the development of subsequent research. Methods: The systematic reviews and meta-analyses on external therapies of traditional Chinese medicine for constipation were retrieved from Chinese and English databases, including China National Knowledge Infrastructure( CNKI),Wanfang Data Knowledge Service Platform(WanFang),China Science and Technology Journal Database (VIP), China Biology Medicine disc (CBM), PubMed, The Cochrane Library, Web of Science, and Embase. The retrieval time was from the inception of each database to August 2025. The methodological quality of the included studies was assessed using the AMSTAR 2 tool;outcome indicators were categorized according to the Nursing Outcomes Classification; data extraction, sorting and coding were completed via Excel, and the evidence was visualized in the form of bubble charts using SPSS27.0 statistical software. Results:A total of 68 systematic reviews/ meta-analyses were ultimately included,primarily involving functional constipation,unspecified chronic constipation, opioid-induced constipation,chemotherapy-induced constipation,stroke-related constipation,constipation in infants and children,and other types of constipation. Among these,studies on functional constipation were the most numerous, with 16 articles,accounting for 23.53%. The involved interventions included acupuncture therapy,acupoint therapy, auricular point therapy, techniques of Tuina and moxibustion, and other external therapies of traditional Chinese medicine. Among them, studies on acupuncture therapy were the most numerous, with 23 studies, accounting for 33.82%. The primary outcome measures included 12 categories, such as the response rate, cure rate, defecation difficulty score, and stool consistency score. Regarding the response rate, the conclusion of 48 studies indicated "beneficial. " There were 5 studies with high-quality evidence, accounting for only 7.35%. Conclusion: External therapies of traditional Chinese medicine demonstrate certain efficacy on constipation; the intervention effects of different external therapies vary, and their application effects in different populations are also significantly different. Most studies lack outcome reports on adverse reactions. In the future,it is still necessary to carry out clinical studies with rigorous experimental design and standardized outcome reports, so as to provide high-quality evidence for the formulation of industry standards such as guidelines and expert consensuses.

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刘志英,向雨璇,毛帅,张建东.中医外治法治疗便秘证据图谱分析[J].新中医,2026,58(20):124-133

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  • 在线发布日期: 2026-10-21
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