大黄联合生长抑素治疗急性重症胰腺炎的系统评价  

Treatment with combination of rhubarb and somatostatin for acute severe pancreatitis: : A systematic review

作　　者：王文进[1] 邵莉莉[2] 颜加云 刘兰[2] 马志远[1] 

机构地区：[1]兰州大学第一医院,甘肃兰州730000 [2]兰州大学第一临床医学院,甘肃兰州730000

出　　处：《现代中西医结合杂志》2014年第1期31-35,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的评价大黄联合生长抑素治疗重症胰腺炎的有效性和安全性。方法计算机检索万方、CNKI、CBM、CQVIP、PubMed、Cochrane library,检索时间从建库到2012年12月31日,最终纳入大黄联合生长抑素治疗重症胰腺炎的随机对照试验。2名评价者独立评价纳入研究的质量并提取资料,用RevMan5.2软件进行分析。结果纳入17篇RCTs,共942例患者。Meta分析结果显示:与单用生长抑素相比,大黄联合生长抑素可以缩短腹痛时间(MD=-1.48,95%CI(-1.79,-1.18),P<0.000 01),能缩短血清淀粉酶的恢复时间(MD=-2.68,95%CI(-4.63,-0.73),P=0.007)及平均住院时间(MD=-7.86,95%CI(-9.97,-5.75),P<0.000 1),也能使首次排便时间提前(MD=-4.80,95%CI(-3.77,-1.57),P<0.000 01),生命体征如体温恢复的时间提前(MD=-2.01,95%CI(-3.53,-0.48),P=0.01),降低并发症的发生率(RR=0.59,95%CI(0.46,0.76),P<0.000 1)及治疗失败的比例(RR=0.57,95%CI(0.42,0.77),P=0.000 3)。结论与单用生长抑素的传统疗法相比,大黄联合生长抑素治疗急性重症胰腺炎有一定的疗效,值得临床参考。Objective It is to evaluate the efficacy and safety of the treatment with somatostatin combined with rhubarb for acute severe pancreatitis （ASP）. Methods We searched relevant randomized controlled trials （RCTs） from WANGFANG, CNKI, CBM, CQVIP ,PubMed, Cochrane library, and included studies of somatostatin combined with rhubarb randomized controlled trials for the treatment of ASP. Two reiewers independently evaluated the quality of these studies and analyzed data by Cochrane Collaboration RevMan5 software. Results 17 RCTs involving 942 patients were included, meta -analysis results showed that compared with the use of somatostatin , somatostatin combined rhubarb can shorten the pain time （ MD = - 1.48, 95% CI （ - 1.79, - 1. 18） , P 〈 0. 000 01 ） , the recovery time of serum amylase （ MD = - 2.68, 95% CI （ - 4.63, - O. 73） , P =0.007） , and average hospitalization days （MD = - 7.86, 95% CI（ - 9.97, - 5.75） , P 〈 0. 000 1 ） , advanced the first defecation time （MD= -4.80, 95%CI （ -3.77, -1.57）, P〈0.00001）, and the vital signs such as body tem- perature recovery time （ M D = - 2.01,95 % CI （ - 3.53, - 0.48 ） , P = 0.01 ） , reduce the incidence of complications （ RR = 0.59, 95 % C I （ 0.46, 0.76 ）, P 〈 0. 000 l ）, reduce the proportion of treatment failure （RR = O. 57, 95% CI （0. 42, 0. 77）, P = 0. 000 3）. Conclusion Compared with the traditional somatostatin therapy alone, rhubarb with somatostatin therapy for ASP has a better curative effect, and is worthing of clinical reference.

关 键 词：大黄 生长抑素 胰腺炎 奥曲肽 思他宁 

分 类 号：R576[医药卫生—消化系统]