云南白药辅助治疗上消化道出血的meta分析

Meta - analysis of Adjuvant Treatment of Upper Gastrointestinal Hemorrhage with Yunnan Baiyao

目的系统评价云南白药辅助治疗上消化道出血的疗效。方法计算机检索Cochranelibrary、PUBMED、EMbase、CNKI、VIP、CBM和Wanfang中关于云南白药对上消化道出血治疗的随机对照试验，同时追索纳人文献的参考文献。检索时限均为从建库到2011年11月。由3名研究者按照Cochrane Handbook for Systematic Reviews of Intervention质量评价标准对纳入研究的质量进行评价和资料提取，对符合质量标准的RCT进行Meta分析，统计学分析采用RevMan5．1．4软件。结果共纳入14个RCT，1449例患者。Meta分析结果显示：云南白药辅助治疗上消化道出血的总有效率和显效率均高于常规治疗，其差异均有统计学意义[OR（95％CI）分别为3．55（2．58，4．86）和2．46（1．68，3．59）]，平均止血时间也短于常规治疗，差异也有统计学意义[SMD=-1．52，95％CI（-2．01，-1．02），P〈0．00001]，每个研究按CochraneHandbook质量评价标准分级均为B级。结论云南白药辅助治疗上消化道出血的总有效率和显效率均有显著的提高，止血时间和输血量均明显降低，且不良反应少，成本较低，值得临床推广应用。

Objective To evaluate Yunnan baiyao on adjuvant treatment of upper gastrointestinal hemorrhage. Methods Cochrane library, PUBMED, EMbase, CNKI, VIP, CBM, and Wanfang were searched for the Randomized controlled trials（RCTs） of Yunnan baiyao on treatment of upper gastrointestinal hemorrhage from the date of establishment of the databases to November 2011. The bibliographies of the included studies were also searched. Three independent researchers evaluated the included studies using Cochrane Handbook for Systematic Reviews of Intervention. The extracted data were analyzed by RevMan 5.1.4. Results Fourteen studies involing 1449 patients met the inclusion criteria. Meta - analyses showed that compared with conventional treatment, the total effective rate and prominent effective rate of upper gastrointestinal hemorrhage treatment were both increased remarkablely（ OR = 3.55,95% CI 2. 58 to 4.86 ; and OR = 2.46,95 % CI 1.68 to 3.59, respectively） and the time of hemorrhage was shorten（ SMD = - 1. 52,95% CI - 2.01 to - 1.02, P 〈 0. 00001 ） after adding Yunnan baiyao to the foundation treatment. Conclusion Yunnan baiyao could improve the curative effect of upper gastrointestinal hemorrhage, shorten hemorrhage time , reduce the amount of blood transfusion and the side effects. It worth extending to hospitals.