中西医结合治疗急性胰腺炎文献的系统评价与Meta分析

Literature System of Assessment and Meta-analysis on Traditional Chinese and Western Medicine Treatment of Acute Pancreatitis

目的:用循证医学的方法评价中药联合西医常规治疗急性胰腺炎的疗效。方法:检索建库至今中国生物医学文献数据库、CNKI数据库、维普数据库、万方数据库发表的有关中药口服联合西医常规治疗急性胰腺炎疗效的随机对照临床试验相关文献。根据纳入及排除标准,有15项临床试验,1267例AP患者(中药口服治疗组665例,对照组602例)纳入本研究。使用Rev Man 5.2软件合并分析纳入研究的急性胰腺炎患者的有效率、血淀粉酶恢复正常时间、腹痛缓解时间、腹痛持续时间及平均住院天数等结局指标。结果:中药口服联合治疗组的有效率合并效应量RR值为4.35,95%CI为(2.97,6.37),Z=7.56,P<0.000 01;χ2=5.70,df=14,P=0.97>0.05,I2=0%,表明15项的研究资料具有同质性,故采用固定效应模型分析。血淀粉酶恢复正常时间WMD=-2.11,95%CI为(-2.45,-1.76),P<0.000 01;腹痛缓解时间WMD=-1.72,95%CI为(-2.18,-1.25),Z=7.26,P<0.000 01;患者平均住院天数WMD=-4.53,95%CI为(-5.82,-3.24),Z=6.88,P<0.000 01,均明显低于对照组,差异有统计学意义。结论:中药口服联合西医常规治疗能显著缩短急性胰腺炎患者腹痛缓解时间,缩短血淀粉酶恢复正常时间,减少患者平均住院天数,明显提高治疗的有效率。

Objective：Use the method of evidence - based medicine to evaluate the effect of traditional Chinese medicine with western medicine routine therapy of acute pancreatitis. Methods ： Retrieve database construction had the Chinese bio-medical literature database, CNKI database, Weipu database, Wanfang database of randomized controlled clinical trial lit-erature about oral medicine combined western medicine routine treatment of acute pancreatitis. According to include and exclude standards,there were 13 clinical trials, 1031 patients with AP （oral medicine treatment group 543 cases, control group 488 cases） included in this study. Use RevMan 5.2 software to analyze acute pancreatitis efficient,blood amylase returned to normal time, abdominal pain, abdominal pain relief time duration and outcome indicators such as the average hospitalization days. Results：Oral medicine combined treatment group＇s effective merger effect of RR was 4.35,95% CI （2.97,6.37） , Z = 7.56, P 〈 0. 000 01. Blood amylase returned to normal time WMD = - 2. 11,95% CI （ - 2.45, - 1.76） ,P 〈 0. 000 01. Abdominal pain relief time WMD = - 1.72,95 % CI （ - 2.18, - 1.25）, Z = 7.26, P 〈 0. 000 01. Average hospitalized days in patients with WMD = -4.53,95% CI （ -5.82, -3.24） ,Z =6.88,P 〈0. 000 01, which were significantly lower than those of the control group. The difference was statistically significant. Conclusion ： Oral medicine with conventional western medicine therapy can significantly shorten the duration and relieve acute pancreatitis patients＇ abdominal pain, shorten the time of blood amylase returned to normal, average hospitalization days and significantly improve the treatment efficiency.