The synergistic effect of herbal medicine and probiotics in pediatric functional constipation: A systematic review and meta-analysis.

Autor:	Kim E; Department of Pediatrics of Korean Medicine, Korean Medicine Hospital, Dongguk University Bundang Medical Center, Gyeonggi-do, Republic of Korea., Chang S; Department of Pediatrics of Korean Medicine, Graduate School of Dongguk University, Seoul, Republic of Korea., Nam J; Sewoon Korean Medicine Clinic, Seoul, Republic of Korea., Park N; Gyeonggi-do Research Institute of Health and Environment, Suwon, Republic of Korea., Min SY; Department of Pediatrics of Korean Medicine, Graduate School of Dongguk University, Seoul, Republic of Korea.; Department of Pediatrics of Korean Medicine, Korean Medicine Hospital, Dongguk University Ilsan Medical Center, Gyeonggi-do, Republic of Korea.
Jazyk:	angličtina
Zdroj:	Medicine [Medicine (Baltimore)] 2024 Feb 16; Vol. 103 (7), pp. e36899.
DOI:	10.1097/MD.0000000000036899
Abstrakt:	Background: Pediatric functional constipation (PFC) is a prevalent and persistent gastrointestinal disorder, that requires various treatments, including alternative approaches. This review assessed the synergistic efficacy of herbal medicine (HM) and probiotics for PFC. Methods: We conducted a comprehensive search of 11 databases, including English, Chinese, and Korean databases, until June 29, 2023. The inclusion criteria were randomized clinical trials (RCTs) comparing the intervention of HM with probiotics to that of the same probiotics. Statistical analyses included calculation of the mean difference (MD), standardized MD, risk ratio (RR) with a 95% confidence interval (CI), and assessment of risk of bias using Review Manager Version 5.4 software. The Grading of Recommendations Assessment, Development, and Evaluation rating system was used to evaluate evidence quality. Potential publication bias was assessed using funnel plots, Egger test, the fail-safe N test, and Duval and Tweedie trim and fill method. Results: A total of 22 RCTs involving 2228 patients were included in the meta-analysis. The HM and probiotics group exhibited superior outcomes compared to the probiotics alone group in various parameters: total effective rate (RR: 1.24, 95% CI: 1.19-1.29, P < .001), Bristol fecal Score (MD: 0.80, 95% CI: 0.71-0.89, P < .001), gastrointestinal peptide hormone (motilin) (MD: 35.37, 95% CI: 24.64-64.10, P < .001), inflammation indicator (nitrous oxide) (MD: -12.45, 95% CI: -15.12 to -9.77, P < .001), minimal sensitive volume of the rectum (MD: -8.7, 95% CI: -10.91 to -6.49, P < .001), and recurrence rate (RR: 0.30, 95% CI: 0.21-0.43, P < .001). Conclusion: The combination of HM and probiotics may exhibit a synergistic effect on PFC. Nevertheless, it is imperative to undertake rigorously planned RCTs to comprehensively evaluate the synergistic efficacy of HM and probiotics. Competing Interests: The authors have no funding and conflicts of interest to disclose. (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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