摘要
目的系统评价大黄与奥曲肽联用治疗急性胰腺炎的有效性和安全性。方法计算机检索中国生物医学文献数据库(CBM)、维普(VIP)、中国知网(CNKI)、PubMed和万方数据库,查找有关应用奥曲肽与大黄联用治疗急性胰腺炎的随机对照试验(RCT),并追索纳入文献的参考文献,检索时限:2008年1月至2014年12月。英文检索词为"Octreotide","rhubarb","ASP",中文检索词为"大黄"、"奥曲肽"、"急性胰腺炎"。2位评价员按照Corchrane系统评价方法,预先制定纳入标准和排除标准,对检索的文献进行独立筛选、数据提取和文献评估,交叉核对相关数据,使用RevMan 5.2软件分析。结果纳入10篇RCT,共655例受试者(试验组336例,对照组319例)。Meta分析结果显示:与单用奥曲肽相比,大黄联合奥曲肽可以提高显效率[RR=1.47,95%CI(1.21,1.78),P<0.01]和总有效率[RR=1.19,95%CI(1.09,1.29),P<0.01];试验组与对照组在缩短腹痛时间、血淀粉酶恢复时间、排便恢复时间、患者住院时间、腹胀消失时间、呕吐消失时间、尿淀粉酶恢复时间、腹压痛消失时间方面,均差异有统计学意义(P<0.01);可降低转手术率,但差异无统计学意义(P>0.05);两组安全性方面未见严重不良反应报道。结论与单用奥曲肽相比,奥曲肽联合大黄治疗急性重症胰腺炎能提高奥曲肽的临床疗效,安全性较好。
Objective To evaluate the efficacy and safety of the treatment with Octreotide combined with rhubarb for acute severe pancreatitis（ASP）. Methods Randomized controlled trials（RCTs） were searched from the following data-bases as CBM, VIP,CNKI,PubMed and WanFang , all RCTs searched from January 2008 to December 2014. Search terms were ＂Octreotide＂,＂ rhubarb＂,＂ASP＂. Two reviewers according to the Cochrane systematic review, pre-defined inclusion and exclusion criteria, then screening literatures, extraction data and assessing literaturer quality independently, finally unifided datas by cross-checked, Meta-a- nalysis was performed by RevMan5. 2 software. Results Ten RCTs involving 655 patients （treatment group.. 336 cases, control group..319 cases） were included. Meta-analysis results showed that compared with the use of Octreotide,Octreotide combined rhu- barb advanced the clinical cure rates[RR = 1.47,95 % CI （ 1.21,1.78）, P〈 0.01] and the total clinical effective rates [RR = 1.19, 95 ; CI（1.09,1.29）,P〈0.01] ;Octreotide combined rhubarb shorted the remission time of abdominal pain, the remission time of vomit, the recovery time of serum amylase, the recovery time of urine amylase, hospitalization days, the first defecation time, the ab- dominal distension disappear time and the remission time of signs of abdominal tenderness, the differences all above showed statisti- cal significance（P〈0.01）. But reducing the proportion of surgery didnr t have statistic difference（P〈0.05）. No severe adverse e- vents or allergic reactions were reported. Conclusion Compared with the traditional Octreotide therapy alone, rhubarb combined with Octreotide therapy for ASP have a better curative effect.
出处
《重庆医学》
CAS
北大核心
2015年第24期3385-3388,3392,共5页
Chongqing medicine
基金
四川省卫生厅资助(130369)
关键词
奥曲肽
大黄属
急性病
胰腺炎
随机对照试验
Octreotide
rheum
acute disease
pancreatitis
randomized controlled trials
