摘要
目的研究中药大黄对百草枯(PQ)中毒患者的临床疗效。方法应用计算机检索中国知网(CNKI)、万方医学网、维普科技期刊数据库(VIP)、中国生物医学文献数据库(CBM)、PubMed、Embase、Web of Science、The Cochrane Library、临床试验注册中心等数据库,获取建库至2022年4月30日的所有相关文献。根据纳入及排除标准筛选出纳入分析的文献,并用Cochrane风险评价工具及MINORS条目评价文献质量,用RevMan 5.3软件对收集的数据进行meta分析。结果纳入21篇文献,随机对照试验(RCT)文献15篇,非随机对照试验(non-RCT)文献6篇,共纳入1902例PQ中毒患者。大黄治疗组PQ中毒患者的病死率[RCT试验:OR=0.49,95%CI(0.37,0.63);non-RCT试验:OR=0.51,95%CI(0.36,0.72)]、肺纤维化发生率[OR=0.34,95%CI(0.24,0.48)]、多器官功能障碍综合征(MODS)发生率[OR=0.26,95%CI(0.16,0.43)]均低于对照组,差异有统计学意义(P<0.05)。结论本研究发现大黄治疗PQ中毒患者能降低病死率、肺纤维化发生率、MODS发生率,但对肝肾功能的影响以及其改善氧合水平方面有待更多研究去探索。
Objective This study was to summarize the beneficial effects of rhubarb on acute paraquat(PQ)poisoning patients by a meta-analysis.Methods Databases,including China National Knowledge Infrastructure(CNKI),Wanfang database,VIP database,China Biology Medicine database,PubMed,Embase,Web of Science,the Cochrane Library,and ClinicalTrials.gov,were searched for related literature from their establishment to April 30,2022.The final literature for meta-analysis was screened under the inclusion and exclusion criteria,evaluated by the Cochrane risk assessment tool and MINORS items and analyzed by RevMan 5.3 software.Results Twenty-one articles,15 RCTs and 6 non-RCTs,were included with 1902 patients.Mortality rate[RCT:OR=0.49,95%CI(0.37,0.63);non-RCT:OR=0.51,95%CI(0.36,0.72)],and incidence of pulmonary fibrosis[OR=0.34,95%CI(0.24,0.48)]and multiple organ dysfunction syndrome(MODS)[OR=0.26,95%CI(0.16,0.43)]of rhubarb treatment group in patients with PQ poisoning were all lower than those of control group,and the difference was statistically significant(P<0.05).Conclusion This study found that rhubarb treatment of patients with PQ poisoning can reduce the mortality rate,and the incidence of pulmonary fibrosis and MODS,but the effects on liver and kidney function and the improvement of oxygenation level need further research to explore.
作者
陈阳
刘剑书
姜道龙
董雪松
CHEN Yang;LIU Jianshu;JIANG Daolong;DONG Xuesong(Department of Emergency,the First Affiliated Hospital of China Medical University,Liaoning Province,Shenyang 110001,China)
出处
《中国当代医药》
CAS
2023年第6期5-10,16,共7页
China Modern Medicine
基金
国家自然科学基金面上项目(81971821)。
