胃管注入大黄治疗急性胰腺炎的系统评价

Rhubarb for acute pancreatitis:A Systematic Review

目的评价大黄治疗急性胰腺炎的有效性和安全性。方法计算机检索Cochrane library(2008年第3期)、PubMed(1966-2008.6)、EMBASE(1974-2008.6),CNKI(1994～2008.6)和VIP(1989～2008.6)等电子数据库,收集有关大黄治疗急性胰腺炎的随机对照试验和/或半随机对照试验,采用Handbook4.2.6推荐的方法评价纳入研究的质量,对符合纳入标准的研究采用RevMan4.2.10进行Meta分析。结果最终纳入12篇中文文献949例患者。Meta分析结果显示:大黄加基础治疗组的治疗有效率明显高于基础治疗组,[RR=1.15,95%CI(1.03,1.27)],其差异具有统计学意义。此外,大黄加基础治疗治疗组的病死率,腹痛持续时间等均低于对照组。结论现有临床证据表明:基础治疗加大黄治疗急性胰腺炎疗效优于基础治疗,但鉴于只纳入了国内研究且质量低,使论证强度受到一定限制,有必要进一步开展高质量、大样本随机临床对照试验评价其疗效和安全性。

Objectiv To assess the effectiveness and safety of rhubarb in the treatment of patients with acute panerefitis. Methods We searched PubMed （1966-2008.6）, EMBASE （1974-2008.6）,The Cochrane Library （issue 3,2008）,Chinese Biomedical Literature Database （1978-2008.6）,China Journal Fulhext Database （1994-2008.6）,Chinese Scientific Journals Fulhext Database（1989-2008.6） etc,eonferenee proceedings, and references of the included studies.conference information and internet information. Randomized controlled trials of acupuncture for rheumatoid arthritis were included, we evaluated the quality of the included studies by Handbook 4.2.6 recommend standard and analyzed data by Cochrane Collaboration＇s RevMan 4.2.10. Results We included 2 randomized controlled trials and 10 quais-randomized controlled trials（n=949）. Meta-analyses showed that the clinical effective rate of rhubarb plus based treatment group significantly was higher than based treatment group [RR=1.15, 95%CI （1.03-1.27）].The mortality of rhubarb plus based treatment group was lower than based treatment group [RR=0.48,95%CI（0.28-0.80） ].The duration of abdominal pain, the mean duration of hospital and complication rate of rhubarb plus based treatment group were lower than based treatment.Conclusion The current evidence showed that rhubarb plus based treatment has better effectiveness when compared with based treatment.Further high quality and large sample randomized controlled trials should be carried out.