中医药联合常规西药对脓毒症胃肠功能障碍疗效的Meta分析
Meta-analysis of the Efficacy of Combined Traditional Chinese Medicine and Conventional Western Medicine for Gastrointestinal Dysfunction in Sepsis
刘茜 1卢伟 2邵旭鹏 1谢娜 1陆佳敏 2张铎 2刘荣飞 2于子洲 2范开亮1
作者信息
- 1. 山东中医药大学附属医院,山东济南 250014
- 2. 山东中医药大学,山东济南 250355
- 折叠
摘要
目的 采用Meta分析对中医药与常规西药联合治疗脓毒症胃肠功能障碍临床疗效和安全性进行评价.方法 计算机检索CBM、VIP、WanFang、CNKI及PubMed数据库2020年1月1日至2024年5月1日中医药治疗脓毒症胃肠功能障碍的临床随机对照试验.依据纳入与排除标准,对文献仔细筛选,提取相应数据,采用RevMan5.4及Stata16.0对数据进行统计分析.结果 36项研究共纳入3 279例脓毒症胃肠功能障碍患者,其中观察组1 644例,对照组1 635例.研究结果提示:相对于单纯常规西药治疗而言,联合中药可显著提高治疗疗效.临床总有效率[OR=3.66,95％CI(2.87,4.67),Z=10.43,P＜0.000 01]、改善胃肠功能障碍评分[MD=-0.60,95％CI(-0.63,-0.56),Z=32.44,P＜0.000 01]、APACHE Ⅱ 评分[MD=-3.90,95％CI(-4.10,-3.71),Z=40.02,P＜0.000 01];降低白细胞计数[MD=-2.20,95％CI(-2.33,-2.08),Z=35.38,P＜0.000 01]、C 反应蛋白[MD=-18.56,95％CI(-18.86,-18.26),Z=122.56,P＜0.000 01]、降钙素[SMD=-1.60,95％CI(-1.76,-1.44),Z=19.11,P＜0.000 01];减轻 28 d 死亡率[OR=0.43,95％CI(0.26,0.72),Z=3.26,P=0.001];安全性良好.结论 中医药与常规西药合用治疗脓毒症胃肠功能障碍患者疗效明显优于常规西药,安全性好.
Abstract
Objective:To evaluate the clinical efficacy and safety of combined traditional Chinese medicine(TCM)and conventional western medicine(CWM)for gastrointestinal dysfunction in sepsis through a meta-analy-sis.Methods:Computerized searches were conducted in the CBM,VIP,WanFang,CNKI,and PubMed databases from January 1,2020,to May 1,2024,for randomized controlled trials(RCTs)involving TCM treatment for gastroin-testinal dysfunction in sepsis.According to inclusion and exclusion criteria,relevant data were extracted and per-formed statistical analysis using RevMan 5.4 and Stata 16.0 software.Results:A total of 36 studies involving 3279 patients with gastrointestinal dysfunction in sepsis were included,with 1 644 patients in the observation group and 1 635 cases in the control group.The results suggested that compared to CWM alone,the combination of TCM and CWM significantly improved treatment efficacy[OR=3.66,95％CI(2.87,4.67),Z=10.43,P＜0.000 01],im-proved gastrointestinal function[MD=-0.60,95％CI(-0.63,-0.56),Z=32.44,P＜0.000 01],and reduced APACHE Ⅱ scores[MD=-3.90,95％CI(-4.10,-3.71),Z=40.02,P＜0.000 01].It also decreased white blood cell count[MD=-2.20,95％CI(-2.33,-2.08),Z=35.38,P＜0.000 01],C-reactive protein levels[MD=-18.56,95％CI(-18.86,-18.26),Z=122.56,P＜0.000 01],and calcitonin levels[SMD=-1.60,95％CI(-1.76,-1.44),Z=19.11,P＜0.000 01];and reduced 28 day mortality rates[OR=0.43,95％CI(0.26,0.72),Z=3.26,P=0.001].The safety was good.Conclusion:The combined use of TCM and CWM for treating gastrointestinal dysfunction in sep-sis demonstrated significantly better efficacy than CWM alone,with good safety.
关键词
脓毒症/胃肠功能障碍/中西医结合/Meta分析/随机对照试验Key words
Sepsis/Gastrointestinal dysfunction/Integration of traditional and western medicine/Meta analysis/RCT引用本文复制引用
出版年
2024
NETL
NSTL
万方数据