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目的:评价从肝脾辨治腹泻型肠易激综合征的临床疗效及安全性.方法:检索PubMed、MEDLINE、SCI、CBM、CNKI、VIP等中英文数据库,检索时间为建库至2016年5月.运用RevMan 5.3软件对提取的有效数据进行Meta分析.结果:共纳入20项研究,合计1836例研究对象.Meta分析结果显示:(1)治疗组(从肝脾辨治方药)的临床总疗效、中医证候疗效合并OR(95％ CI)值分别为3.46[2.58,4.65]、2.65[1.82,3.87],均优于匹维溴铵组,差异有统计学意义(P＜0.05).(2)治疗组与匹维溴铵组相比,其复发率合并OR(95％CI)值为0.18[0.09,0.34],差异有统计学意义(P＜0.05).(3)对纳入研究的1836例腹泻型肠易激综合征病例进行不良反应/事件观察,治疗组共出现3例不良反应/事件,为口干、腹泻、腹痛,而对照组出现14例不良反应/事件,多表现为便秘、恶心、口干、上腹部不适、腹痛、腹泻等症状.不良反应发生率合并OR(95％CI)值为0.25[0.08,0.76],差异有统计学意义(P＜0.05).结论:从肝脾辨治腹泻型肠易激综合征,在临床总疗效、中医证候疗效方面,优于单纯的匹维溴铵组,且匹维溴铵组的复发率明显高于治疗组,此外,从肝脾辨治方药的长时间服用未出现明显不良反应,安全性较好.“,”Objective:To approach the effectiveness and safety of dialectical treatment of diarrhea-predominant irritable bowel syndrome (IBS-D) from Liver and Spleen.Methods:Studies were identified by searching PubMed,MEDLINE,and web of science (SCI),CBM,CNKI and VIP databases.Retrieving time was from database creation until May 2016.Review Manager 5.3 software was used to extract the effective data for metaanalysis.Results:We identified 20 studies,including 1836 patients.The meta-analysis showed that the total effective and the efficacy of Traditional Chinese Medicine (TCM) Syndrome with OR [95％ CI] of the treatment group (Dialectical treatment of IBS-D from Liver and Spleen with TCM) were respectively 3.46[2.58,4.65] and 2.65[1.82,3.87],which were statistically significant,compared with the Pinaverium Bromide group;Compared with the Pinaverium Bromide group,the recurrence rate of the treatment group with OR [95％CI] of the treatment group was 0.18 [0.09,0.34],and the difference was statistically significant (P＜0.05);Adverse drug reactions / events of the enrolled 1836 patients with IBS-D were observed,with 3 cases of dry mouth,diarrhea,abdominal pain in the treatment group versus 14 cases of constipation,nausea,dry mouth,abdominal discomfort,abdominal pain,diarrhea etc.in the Pinaverium Bromide group.Incidences of Adverse drug reactions with OR [95％CI] was 0.25 [0.08,0.76],which was statistically significant (P＜0.05).Conclusions:Dialectical treatment of IBS-D from Liver and Spleen with TCM is superior to the group with Pinaverium Bromide in terms of the total effective and the efficacy of TCM Syndrome.And the recurrence rate of the control group was significantly higher than the treatment group.In addition,the treatment group shows no obvious adverse effects and with high safety resulting from the long time taking prescription from Liver and Spleen.