Da Cheng Qi Tang for Intestinal Obstruction is Reviewed
This study was aimed at determining the effects and safety
of Da-Cheng-Qi decoction (DCQD) or DCQD combined with conservative therapy in
patients with intestinal obstruction. PubMed, EMBASE, Cochrane Controlled
Trials Register, and several other databases were searched. Randomised
controlled trials (RCTs) of DCQD or DCQD plus conservative therapy in patients
with intestinal obstruction were eligible. Therapeutic effect was estimated by
the improvement of clinical manifestations and diagnostic imaging;
dichotomous/ordinal data assessment of overall response to therapy, adverse
effects; or continuous variable were identified, including time to first bowel
movement, time to first flatus, length of hospital stay. Sixty eligible RCTs
including 6,095 patients were identified. Response rate: (1) DCQD versus
conservative therapy (6 RCTs, 361 patients, RR of respond =1.13; 95% CI 0.97 to
1.31). (2) DCQD plus conservative therapy versus conservative therapy (48 RCTs,
4,916 patients, RR of respond =1.25 which favoured DCQD plus conservative
therapy; 95% CI 1.20 to 1.30). Treatment effect remained similar when RCTs at
high risk of bias were excluded. Time to first flatus postoperatively: (1) DCQD
versus conservative therapy (2 RCTs, 240 patients, SMD=-3.65; 95% CI -8.17 to
0.87). (2) DCQD plus conservative therapy versus conservative therapy (11 RCTs,
1,040 patients, SMD=-2.09 which favoured DCQD plus conservative therapy; 95% CI
-3.04 to -1.15). DCQD combined with conservative therapy may increase the
success rate of conservative therapy for intestinal obstruction significantly
and can shorten the duration of postoperative ileus in patients undergoing
abdominal surgery compared with conservative therapy alone.
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