大黄相关复方联合西医常规治疗急性胆囊炎的Meta分析

Rhubarb Related Compound Combined with Conventional Western Medicine in the Treatment of Acute Cholecystitis:A Meta-analysis

目的:系统评价大黄相关复方联合西医常规治疗急性胆囊炎的临床疗效及其安全性。方法:计算机检索CNKI、VIP、WanFang、SinoMed、PubMed、Embase等数据库,对有关采用大黄相关复方联合西药治疗急性胆囊炎的临床随机对照试验(RCT)研究进行筛选,运用RevMan5.3软件对数据进行Meta分析。结果:共纳入42项研究,合计4145例急性胆囊炎患者(大黄实验组2101例,对照组2044例)。纳入的研究质量一般,Meta分析结果显示:大黄实验组的临床总有效率高于对照组[RR=1.18,95%CI(1.15,1.21)];从临床症状缓解时间上看,与对照组相比,大黄实验组腹痛缓解时间短[MD=-2.20,95%CI(-2.87,-1.54)];退热时间短[MD=-1.55,95%CI(-2.04,-1.07)];恶心呕吐缓解时间短[MD=-3.08,95%CI(-3.65,-2.51)],差异均有统计学意义(P<0.001);大黄实验组不良反应发生率较小[RR=0.51,95%CI(0.31,0.85)];不同的主治偏向的大黄相关复方中,检验无异质性,但对急性胆囊炎都有一定的治疗作用(P<0.001)。结论:大黄相关复方能够明显提高急性胆囊炎临床有效率,缩短临床症状持续时间,减少不良反应的发生,各主治偏向之间无异质性。

Objective The clinical efficacy and safety of rhubarb-related compounds combined with conventional western medicine in the treatment of acute cholecystitis were systematically reviewed.Methods CNKI,VIP,WanFang,SinoMed,PubMed,Embase and other databases were searched by computer to analyze the clinical efficacy and safety of rhubarb-related compounds combined with western medicine in the treatment of acute cholecystitis.Randomized controlled trials(RCTs)were screened,and RevMan5.3 software was used to conduct Meta-analysis of the data.Results A total of 42 studies were included,with a total of 4145 patients with acute cholecystitis(rhubarb experimental group=2101,control group=2044).The quality of the included studies was average.The total clinical effective rate was higher than that of the control group[RR=1.18,95%CI(1.15,1.21)];in terms of clinical symptom relief time,the abdominal pain relief time of the rhubarb experimental group was shorter than that of the control group[MD=-2.20,95%CI(-2.87,-1.54)];short time to relieve fever[MD=-1.55,95%CI(-2.04,-1.07)];short time to relieve nausea and vomiting[MD=-3.08,95%CI(-3.65,-2.51)],the difference was statistically significant(P<0.001);in terms of adverse reactions,the rhubarb experimental group had fewer adverse reactions[RR=0.51,95%CI(0.31,0.85)];different indications biased Among the rhubarb-related compounds in the test,there was no heterogeneity in the test,and they had a certain therapeutic effect on acute cholecystitis(P<0.001).Conclusion The rhubarb-related compound can significantly improve the clinical efficacy of acute cholecystitis,shorten the duration of clinical symptoms,and reduce the occurrence of adverse reactions.