大柴胡汤联合西医治疗重症急性胰腺炎疗效的Meta分析

Meta-Analysis of Efficacy of Dachaihu Decoction(大柴胡汤) in Treatment of Severe Acute Pancreatitis

目的:系统评价大柴胡汤联合西医常规治疗重症急性胰腺炎的疗效,为中医治疗重症胰腺炎提供临床循证医学证据。方法:制定文献纳入标准、排除标准及检索策略,检索Pubmed、EMBASE、Cochrane Library、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。结果:共纳入13个随机对照实验,试验组总有效率[OR=5.48,95%CI(3.22,9.34),P<0.000,01],腹痛缓解时间[MD=-1.53,95%CI(-2.11,-0.95),P<0.000,01],病死率[OR=0.36,95%CI(0.15,0.87),P=0.02],APACHEⅡ评分[MD=-2.57,95%CI(-3.03,-2.10),P <0.000,001],平均住院时间[MD=-3.85,95%CI(-5.03,-2.68),P<0.000,01]均优于对照组,差异有统计学意义。结论:大柴胡汤能明显提高治疗总有效率,降低病死率,减少SAP患者平均住院时间,缩短SAP患者腹痛缓解时间。提示大柴胡汤联合西医在治疗重症胰腺炎过程中比单纯西医治疗更具优势。

Objective: To systematically evaluate the effectiveness of Dachaihu decoction in the treatment of severe acute pancreatitis, to provide evidence-based medical evidence for the treatment of severe pancreatitis with traditional Chinese medicine. Methods: The inclusion and exclusion criteria and retrieval strategies were made. CNKI, Wanfang Data Knowledge, Service Platform, Chinese Biomedical Database, Pubmed and other Chinese and English databases were retrieved. Results: The 13 studies were included. The treatment group showed better total effective rate [OR =5.48,95% CI(3.22,9.34), P<0.000,01], the time of stomach ache relief [MD =-1.53,95%CI(-2.11,-0.95),P<0.000,01], case fatality rate [MD=0.36, 95 CI%(0.15, 0.87), P=0.02], APACHEⅡscore[MD=-2.57, 95%CI(-3.03,-2.10), P<0.000,001], hospital stay(days)[MD=-3.85, 95%CI(-5.03,-2.68), P<0.000,01]than control group. Conclusion: The Dachaihu decoction can significantly improve the total efficiency, reduce the case fatality rate, reduce the average length of hospital stay and significantly shorten the time required for severe acute pancreatitis patients with abdominal pain relief. It is suggested that Dachaihu decoction combined with western medicine is more advantageous than western medicine in the treatment of severe pancreatitis.