Abstract Background Functional constipation is highly prevalent and places a significant burden on healthcare systems around the world. Manual therapy is a commonly used intervention, however to date there has not been a systematic review that critically appraises a wide range of manual therapy disciplines. Objectives To systematically review the literature and analyse the methodological quality of all included studies, and to provide an overall level of evidence analysis. Methods A database search was completed to identify eligible studies that were published from database creation to July 2018. The relevant characteristics of each study were extracted, and each study was assessed for methodological quality with a modified version of the Downs and Black appraisal tool. Results Seven studies fulfilled the inclusion criteria and were assessed for methodological quality. One study was found to have ‘strong’ methodological quality, five were of ‘moderate’ quality, and one was of ‘low’ quality. All studies reported consistent findings regarding their individual primary outcome measures. Overall level of evidence for the use of manual therapy as an intervention for constipation was found to be ‘moderate’. Conclusions There is moderate quality evidence for the use of manual therapy as an intervention for constipation. The review identified several themes that can guide future research on this topic, including intervention type and frequency, reporting quality, mechanism of effect, and variability of outcome measures.

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手法治疗方法能否改善功能性便秘的症状？文献系统回顾

摘要背景功能性便秘非常普遍，给世界各地的医疗保健系统带来了沉重的负担。手法治疗是一种常用的干预措施，但迄今为止，还没有系统评价对范围广泛的手法治疗学科进行批判性评价。目的 系统地回顾文献并分析所有纳入研究的方法学质量，并提供总体水平的证据分析。方法 完成数据库搜索以识别从建库至 2018 年 7 月发表的符合条件的研究。提取每项研究的相关特征，并使用修改版的 Downs and Black 评估工具评估每项研究的方法学质量。结果 七项研究符合纳入标准，并进行了方法学质量评估。一项研究被发现具有“强”的方法学质量，五项是“中等”质量，一项是“低”质量。所有研究都报告了关于其个人主要结局指标的一致结果。使用手法治疗作为便秘干预的总体证据水平被认为是“中等”。结论 有中等质量的证据表明使用手法治疗作为便秘的干预措施。该评价确定了可以指导该主题未来研究的几个主题，包括干预类型和频率、报告质量、效果机制和结果测量的可变性。五个是“中等”质量，一个是“低”质量。所有研究都报告了关于其个人主要结局指标的一致结果。使用手法治疗作为便秘干预的总体证据水平被认为是“中等”。结论 有中等质量的证据表明使用手法治疗作为便秘的干预措施。该评价确定了可以指导该主题未来研究的几个主题，包括干预类型和频率、报告质量、效果机制和结果测量的可变性。五个是“中等”质量，一个是“低”质量。所有研究都报告了关于其个人主要结局指标的一致结果。使用手法治疗作为便秘干预的总体证据水平被认为是“中等”。结论 有中等质量的证据表明使用手法治疗作为便秘的干预措施。该评价确定了可以指导该主题未来研究的几个主题，包括干预类型和频率、报告质量、效果机制和结果测量的可变性。结论 有中等质量的证据表明使用手法治疗作为便秘的干预措施。该评价确定了可以指导该主题未来研究的几个主题，包括干预类型和频率、报告质量、效果机制和结果测量的可变性。结论 有中等质量的证据表明使用手法治疗作为便秘的干预措施。该评价确定了可以指导该主题未来研究的几个主题，包括干预类型和频率、报告质量、效果机制和结果测量的可变性。