目的采用Meta分析评价聚乙二醇(PEG)对治疗儿童功能性便秘的临床疗效。方法计算机检索Medline、Pubmed、Cochrane数据库、Embase、维普数据库、万方数据库和中国学术期刊全文数据库资源,检索时限均从建库至2016年12月,收集国内外应用PEG治疗儿童功能性便秘的所有随机对照试验或前瞻性对比研究。采用Revman5.3软件对纳入文献进行风险偏倚评估。采用Stata11.0软件对纳入文献进行Meta数据分析,并计算各文献合并的标准化均数差(SMD)及其95%置信区间(95%CI),通过分析PEG治疗组和非PEG治疗组临床效应指标的差别来了解PEG治疗儿童功能性便秘的临床效果。结果经计算机初步检索和纳入排除标准选择文献,最终纳入Meta分析的文献为7篇。合计纳入研究患儿662例,其中PEG治疗组318例,非PEG治疗组344例。Meta分析结果:主要效应指标“每周大便次数”按照对照组措施不同绘制的森林图显示,PEG治疗组临床主要效应指标显著高于乳果糖组。按照临床疗效观察时间点不同绘制的森林图显示,PEG治疗组临床主要效应指标显著高于非PEG治疗组。次要效应指标“大便性状改善”按照不同观察时间点进行Meta分析后发现,PEG治疗组在大便性状改善上显著高于非PEG治疗组。结论PEG治疗儿童功能性便秘安全有效。
Objective To evaluate the clinical efficacy of polyethylene glycols(PEG)on functional constipation in children by Meta-analysis.Methods The Medline,Pubmed,Cochrane database,Embase,VIP database,China Knowledge Resource Integrated Database(CNKI)and WANFANG MED ONLINE resources were reviewed for the treatment with polyethylene glycols on functional constipation in children from the inception to December2016to collect all randomized controlled trials(RCTs)or comparative prospective studies.Revman5.3software was used to assess risk of bias of the Cochrane Collaboration’s tool.A Meta analysis of the therapeutic effect of polyethylene glycols on functional constipation in children was conducted by Stata11.0software.The pooled standardized mean difference(SMD)and95%confidence interval(95%CI)were calculated in order to know the clinical efficacy of polyethylene glycols on functional constipation in children.Results Seven literatures were included in our Meta analysis.There were662children were included in this study,and they were divided into PEG treatment group(n=318)and non-PEG treatment group(n=344).The forest plot results of Meta analysis showed that the main effect index“weekly stool frequency”was significantly higher in PEG treatment group than that of lactulose group,according to the different control measures.The main effect index“weekly stool frequency”was significantly higher in PEG treatment group than that of non-PEG treatment group,according to the mapping forest chart displayed different clinical effect observation time points.Results from Meta analysis showed that the secondary effect index“successful stool consistency improvement”was significantly higher in PEG treatment group than that of non-PEG treatment group,according to different observation time points.Conclusion Polyethylene glycols is safe and effective in the treatment of functional constipation in children.