摘要
目的对国内外已发表的有关利胆退黄法治疗胆源性胰腺炎临床疗效进行Meta分析。方法计算机检索Pubmed、Cochrane Library、CNKI、VIP、Wan Fang Data、CBM、PHM以及CSCI数据库,检索时限为建库至2018年6月,2名评价者独立筛选文献、提取资料和评价纳入研究偏倚后,采用Rev Man5. 3软件进行Meta分析。结果最终纳入11项随机对照试验(RCT),总病例数841例。分析结果显示,与对照组比较,利胆退黄法联合常规西药治疗急性胆源性胰腺炎(ABP)临床有效率更高[OR=3. 67,95%CI(1. 93,7. 01),P <0. 000 01],并能降低血淀粉酶[MD=-33. 35,95%CI(-42. 95,-23. 74),P <0. 000 01]、尿淀粉酶水平[MD=-133. 93,95%CI(-151. 60,-116. 26),P <0. 000 01];缩短血淀粉酶恢复时间[MD=-1. 67,95%CI(-2. 59,-0. 76),P <0. 000 01]、尿淀粉酶恢复时间[MD=-0. 95,95%CI(-1. 02,-0. 88),P <0. 000 01];降低CRP水平[MD=-7. 17,95%CI(-8. 06,-5. 74),P <0. 000 01];明显缩短住院时间[MD=-2. 31,95%CI(-2. 68,-1. 93),P <0. 000 01]。结论在常规治疗ABP的基础上联合利胆退黄法,可提高临床疗效,降低血、尿淀粉酶水平,减少炎症反应发生,缩短患者住院时间。但纳入文献质量偏低,需高质量RCT进一步验证。
Objective To conduct the meta-analysis on the clinical efficacy of lidan tuihuang method(the therapy for benefiting the gallbladder and reducing jaundice)on acute biliary pancreatitis.Methods The Pubmed,Cochrane Library,CNKI,VIP,Wanfang data,CBM,PHM and CSCI databases were retrieved from the time of database establishment to June 2018.2 reviewers screened the literatures,extracted data and evaluated the bias of the included trials independently.Afterwards,using RevMan 5.3 software,the meta-analysis was conducted.Results Finally,11 RCTs were included,with 841 cases.The analysis results showed that compared with the control group,the clinical effective rate of the combined medication of lidan tuihuang method and the routine western medicine was much higher in the treatment of acute biliary pancreatitis[ OR=3.67,95% CI(1.93,7.01),P<0.000 01].The treatment reduced amylase in blood[ MD=-33.35,95% CI(-42.95,-23.74),P<0.000 01]and in urine[ MD=-133.93,95% CI(-151.60,-116.26),P<0.000 01],shortened the recovery time of amylase in blood[ MD=-1.67,95% CI(-2.59,-0.76),P<0.000 01]and in urine[ MD=-0.95,95% CI(-1.02,-0.88),P<0.000 01],reduced CRP[ MD=-7.17,95% CI(-8.06,-5.74),P<0.000 01]and obviously shortened the length of stay[ MD=-2.31,95% CI(-2.68,-1.93),P<0.000 01].Conclusion On the base of the routine treatment of acute biliary pancreatitis,lidan tuihuang method improves the clinical efficacy,reduced amylase in blood and urine and the inflammatory reaction,and shortens the length of stay.But,the quality of the included literatures is low.It needs the RCTs of the high quality to give a further verification.
作者
孙武
刘宝清
杨成城
张少辉
余文
门斯烨
SUN Wu;LIU Bao-qing;YANG Cheng-cheng;ZHANG Shao-hui;YU Wen;MEN Si-ye(Beijing University of Traditional Chinese Medicine,Beijing 100029;Dongfang Hospital Affiliated to Beijing University of Traditional Chinese Medicine,Beijing 100078)
出处
《世界中西医结合杂志》
2019年第1期22-28,共7页
World Journal of Integrated Traditional and Western Medicine
基金
北京中医药大学硕士研究生自主课题(2018-JYBZZ-XS211)
