摘要
目的评价大黄附子汤治疗成人脓毒症胃肠功能障碍的疗效及安全性。方法由2名研究人员分别独立通过计算机检索PubMed、Cochrane临床试验数据库、Medline、中国知网(CNKI)、万方数据库、中国生物医学文献数据库(CBM)、维普中文期刊数据库建库至2019年8月公开发表的关于大黄附子汤治疗成人脓毒症急性胃肠功能障碍的随机对照临床试验,同时检索纳入文献的参考文献,并独立对纳入的参考文献进行质量评价和数据提取,采用RevMan5.3软件进行Meta分析。结果1)最终纳入6篇文献、共518例患者,Jadad量表评分均≥3分;各研究均是随机入组并明确指出组间基线具有可比性;1篇文献使用了盲法。2)大黄附子汤联合西医常规治疗组在胃肠功能评分[MD=-0.35,95%CI(-0.58,-0.12)]、胃肠功能Ⅲ级发生率[OR=0.26,95%CI(0.13,0.55)]、急性生理与慢性健康(APACHEⅡ)评分[MD=-4.23,95%CI(-5.01,-3.44)]方面优于单纯西医治疗组,在28 d病死率方面组间无统计学差异(P>0.05)。结论大黄附子汤有助于改善脓毒症胃肠功能障碍及病情,未出现明显不良反应。
Objective:To evaluate the efficacy and safety of Dahuang Fuzi Decoction combined with Western medicine on sepsis-related gastrointestinal dysfunction.Methods:PubMed,Cochrane Central Register of Controlled Trials,Medline,CNKI,WanFang database,CBMdisc and VIP database were searched to identify RCTs about Dahuang Fuzi Decoction on sepsis-related gastrointestinal dysfunction from the foundation of the various databases to August 2019 by two researchers.The references of the included literature were retrieved.The quality evaluation and data extraction of the included literature were carried out,and the RevMan5.3 software was used for meta analysis.Results:1)6 studies involving 518 patients were identified and enrolled.6 studies had a Jadad score≥3.The random method was used and the intergroup baseline data was clearly indicated in all the studies.The blind method was applied in 1 contained RCT.2)Dahuang Fuzi Decoction combined with conventional Western medicine could improve gastrointestinal function score[MD=-0.35,95%CI(-0.58,-0.12)],GradeⅢincidence of gastrointestinal function[OR=0.26,95%CI(0.13,0.55)]and APACHEⅡscorces[MD=-4.23,95%CI(-5.01,-3.44)],superior to the control group.There was no significant difference in 28-day mortality between the two groups(P>0.05).Conclusion:Dahuang Fuzi Decoction is helpful to improve gastrointestinal dysfunction and condition of sepsis,without obvious adverse reactions.
作者
刘锦
李慧慧
刘福生
Liu Jin;Li Huihui;Liu Fusheng(Dong Zhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)
出处
《中国中医急症》
2020年第8期1365-1369,共5页
Journal of Emergency in Traditional Chinese Medicine
基金
中央高校基金资助项目(2019-JYB-jspygd011,2018-JYBZZ-JS075)。
