Effect of traditional Chinese medicine external therapy for functional constipation: a meta-analysis.

OBJECTIVE: To systematically review the effectiveness and safety of external treatment with traditional Chinese medicine in patients with functional constipation. METHODS: In this meta-analysis study, we searched for randomized controlled trials (RCTs) on traditional Chinese medicine (TCM) external therapy for treating functional constipation from various databases. Search time was from database establishment to May 2022. The included studies were evaluated for meta-analysis using RevMan 5.3 software. RESULTS: A total of 18 randomized controlled studies were included, including 1404 patients. Results showed the total effective rate [OR = 3.83, 95% CI (2.71, 5.43), P < 0.01] and quality of life [OR = -9.78, 95% CI (-12.32, -7.23), P < 0.01] effectively improved after TCM external therapy; constipation symptoms [OR = -1.64, 95% CI (-2.31, -0.96), P < 0.01] reduced; defecation time [OR = -0.68, 95% CI (-0.99, -0.37), P < 0.01] shortened and spontaneous complete bowel movements (SCBM) [OR = 0.48, 95% CI (0.01, 0.95), P < 0.05] increased; and recurrence rate [OR = 0.25, 95% CI (0.17, 0.38), P < 0.01] reduced. The results of a subgroup analysis of the types of TCM treatment showed acupoint catgut embedding [OR = 3.04, 95% CI (1.10, 8.41), P < 0.05], acupoint application [OR = 3.46, 95% CI (1.74, 6.89), P < 0.01], manipulation [OR = 4.26, 95% CI (0.81, 22.53), P > 0.05], the combination of two external treatment methods [OR = 7.73, 95% CI (3.00, 19.91), P < 0.01], acupuncture [OR = 3.09, 95% CI (1.21, 7.85), P < 0.05], and other external therapies [OR = 3.58, 95% CI (1.89, 6.80), P < 0.01] had certain value in treating functional constipation. CONCLUSIONS: TCM external therapy has good clinical efficacy in treating functional constipation (FC) patients, which can improve main treatment efficacy and life quality, reduce constipation symptoms, shorten defecation time and SCBM, and reduce the recurrence rate. This therapy has no adverse reaction and can be widely applied in clinical practice.