系统评价血必净注射液对重症急性胰腺炎患者炎症因子的影响

Effect of Xuebijing Injection on Inflammatory Mediators in Patients with Severe Acute Pancreatitis:A Systematic Review

目的:系统评价血必净注射液对重症急性胰腺炎(SAP)患者炎症因子的影响,为临床提供循证参考。方法:计算机检索Pub Med、中国期刊全文数据库、中国生物医学文献数据库、中文科技期刊数据库和万方数据库,收集血必净注射液对SAP患者炎症因子影响的随机对照试验(RCT),提取资料和评价纳入研究的偏倚风险后,采用Rev Man 5.2统计软件进行Meta分析。结果:共纳入10项RCT,合计811例患者。Meta分析结果显示,血必净注射液能显著降低SAP患者白细胞介素(IL)-1水平[SMD=1.22,95%CI(0.64,1.79),P<0.001]、IL-6水平[SMD=1.86,95%CI(1.46,2.27),P<0.001]、IL-8水平[SMD=2.16,95%CI(1.45,2.88),P<0.001]、肿瘤坏死因子水平[SMD=2.16,95%CI(1.56,2.76),P<0.001]、C反应蛋白水平[SMD=1.63,95%CI(0.56,2.70),P<0.001]和内毒素水平[SMD=2.39,95%CI(1.33,3.45),P<0.001],还能显著提高SAP患者IL-10水平[SMD=-2.75,95%CI(-3.84,-1.67),P<0.001],差异均有统计学意义。结论:在常规治疗的基础上,血必净注射液可以显著改善SAP患者各种炎症因子水平。

OBJECTIVE： To systematically review the effect of Xuebijing injection on inflammatory mediators in patients with severe acute pancreatitis （SAP） , and provide evidence-based reference for clinic. METHODS： Retreived from PubMed, CJFD, CBM, VIP and Wanfang Database, randomized controlled trials （RCT） about the effect of Xuebijing injection on inflammatory me- diators in patients with SAP were collected. Meta-analysis was performed by using Rev Man 5.2 software after data extraction and bias risk evaluation. RESULTS： Totally 10 RCTs, involving 811 patients. Results of Met-analysis showed, Xuebijing injection can significantly reduce IL-1[SMD=1.22, 95% CI （0.64, 1.79） , P〈0.001], IL-6[SMD=1.86, 95% CI （1.46, 2.27）, P〈0.001], IL-8 [SMD=2.16, 95 % CI （1.45,2.88）, P〈0.001], TNF-α [SMD=2.16, 95 % CI （1.56,2.76）, P〈0.001], C-reactive protein [SMD= 1.63, 95% CI （0.56,2.70）, P〈0.001] and endotoxin [SMD= 2.39,95% CI （1.33,3.45）, P〈0.001], and it also can significantly improve IL-10[SMD=-2.75,95%CI（-3.84,-1.67）,P〈0.001], with statistical significance. CONCLUSIONS： Based on conventional trecotment,Xuebijing injection can significantly improve inflammatory mediators in patients with SAP.