Da-cheng-qi decoction, a traditional Chinese herbal formula, for intestinal obstruction: systematic review and meta-analysis.
BACKGROUND
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.


METHODS
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.


RESULTS
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).


CONCLUSIONS
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.
Kidney institute of CPLA, Division of Nephrology, Changzheng hospital, Second Military Medical University, Shanghai, China.
Bo
B
Yang
Department of Anesthesiology, Changzheng Hospital, Second Military Medical University, Shanghai, China.
Feng-Ying
FY
Xu
Department of Anesthesiology, Changzheng Hospital, Second Military Medical University, Shanghai, China.
Hai-Jing
HJ
Sun
Department of Anesthesiology, Changzheng Hospital, Second Military Medical University, Shanghai, China.
Zui
Z
Zou
Department of Anesthesiology, Changzheng Hospital, Second Military Medical University, Shanghai, China.
Xue-Yin
XY
Shi
Department of traditional Chinese medicine, Changhai Hospital Second Military Medical University, Shanghai, China.
Chang-Quan
CQ
Ling
Department of traditional Chinese medicine, Changhai Hospital Second Military Medical University, Shanghai, China.
Ling
L
Tang
D002957:Citrus; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D006801:Humans; D007415:Intestinal Obstruction / Q000188:drug therapy* / Q000628:therapy; D031566:Magnolia; D019684:Magnoliopsida; D008517:Phytotherapy; D011183:Postoperative Complications / Q000188:drug therapy; D012250:Rheum
C551430:Da-Cheng-Qi; D004365:Drugs, Chinese Herbal
Da-Cheng-Qi-Tang; Ileus; Intestinal Obstruction; Intestinal Pseudo-Obstruction; Meta-Analysis