Chinese Herbal Enema plus Gastrointestinal Intubation for Ileus: A Systematic Review

Objective To systematically review the efficacy of Chinese herbal enema in ileus patients. Methods The randomized controlled trials(RCTs) and quasi-RCTs about Chinese herbal enema and gastrointestinal intubation versus western medicines in the treatment of ileus disease was searched in PubMed, Web of Science, EMbase, The Cochrane Library(Issue 4, 2013), CBM, CNKI, VIP and WanFang Data from the date of their establishment to July 2013. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of included studies. Then meta-analysis was performed using RevMan 5.1. Results A total of 27 RCTs and 3 quasi-RCTs involving 3 074 patients were included. The results of meta-analysis showed that the Chinese herbal enema and gastrointestinal intubation group was superior to the control group in raising the total clinical effective rate(OR=4.69, 95%CI 3.70 to 5.94, P0.00001), as well as shortening the hospitalization time(SMD= –1.19, 95%CI –1.42 to –0.96, P0.00001), time of anus exhaust(SMD= –1.52, 95%CI –1.76 to –1.28, P0.00001), defecation(SMD= –2.27, 95%CI –3.43 to –1.11, P=0.0001), time of gastric tube indwelling(SMD= –1.56, 95%CI –1.86 to –1.27, P0.00001), and symptoms complete resolution(SMD= –0.74, 95%CI –1.11 to –0.37, P0.0001), all with significant differences. Conclusion Chinese herbal enema and gastrointestinal intubation is more beneficial than western medicine alone for ileus. Due to limited quality of the included studies, the abovementioned conclusion still needs to be verified by conducting more high quality blinding RCTs.