$re = '/(comment_approved\s=\s\'(?:1|0)\')|\(\s(comment_approved\s=\s\'0\'\sOR\scomment_approved\s=\s\'1\')\s\)/';
$str = '( comment_approved = \'0\' OR comment_approved = \'1\' ) AND ( (CAST(wp_72423799_commentmeta.meta_value AS SIGNED) >= \'1409095998\') ) AND (wp_72423799_commentmeta.meta_key = \'o2_comment_gmt_modified\' )
';
$subst = "( $1$2 OR comment_approved = \'trash\' )";
$result = preg_replace($re, $subst, $str, 1);
echo "The result of the substitution is ".$result;
Please keep in mind that these code samples are automatically generated and are not guaranteed to work. If you find any syntax errors, feel free to submit a bug report. For a full regex reference for PHP, please visit: http://php.net/manual/en/ref.pcre.php