生长抑素联合奥美拉唑治疗急性胰腺炎的系统评价  

Systematic Review on Somatostatin Combined with Omeprazole for Treating Acute Pancreatitis

作　　者：米婷婷[1,2] 范开华[1] 张育勤[1] 任建东[1] 

机构地区：[1]中国人民解放军成都军区总医院药剂科,四川成都610083 [2]泸州医学院药学院,四川泸州646000

出　　处：《中国药业》2015年第11期14-17,共4页China Pharmaceuticals

摘　　要：目的系统评价生长抑素联合奥美拉唑治疗急性胰腺炎(AP)的疗效和安全性。方法计算机检索中国期刊全文数据库(CNKI,1990至2014年)、中文科技期刊数据库(VIP,1989至2014年)、中国生物医学文献数据库(CBM,1990至2014年)、Pub Med(1980至2014年)、万方数据库(Wan Fang Data,1990至2014年)、Medline(1990至2014年)生长抑素联合奥美拉唑治疗AP的随机对照试验(RCT),采用Rev Man 5.2软件进行Meta分析。结果纳入4篇RCT,共计464例,其中试验组和对照组,各232例。Meta分析结果显示,在常规治疗基础上加用生长抑素和奥美拉唑治疗AP能提高治疗有效率[RR=1.32,95%CI(1.20,1.44),P<0.000 01],降低并发症发生率[RR=0.16,95%CI(0.09,0.30),P<0.000 01]和病死率[RR=0.36,95%CI(0.17,0.80),P=0.01],能缩短平均住院时间,还能缩短腹痛腹胀时间[MD-1.63,95%CI(-2.08,-1.18),P<0.000 01]以及血淀粉酶恢复时间[MD-3.20,95%CI(-3.76,-2.64),P<0.000 01]。结论在常规治疗基础上加用生长抑素和奥美拉唑治疗AP,较一般常规治疗疗效显著。但由于本系统评价纳入研究的质量较低,可能影响了结果的论证强度,期待更多高质量的随机双盲对照试验以提供更高质量的证据。Objective To systematically assess the therapeutic effect ment of acute pancreatitis（AP）. Methods The randomized controlled and safety of somatostatin combined with omeprazole for the treattrails（RCTs） on somatostatin combined with omeprazole for treating AP were retrieved from the databases of NKI（1990- 2014.01）, VIP（1989- 2014.01）, CBM（1990- 2014. 01）, PubMed（1980- 2014.01）, WauFang Data（1990- 2014.01） and Medline（1990 - 2014. 01） by computer, and the meta-analysis was performed by using the RevMan 5.2 software. Results Four RCTs involving 464 cases were included, among which 232 cases were in the treatment group and the control group respectively. The results of meta- analysis indicated that on the basis of the conventional treatment, somatostatin combined with omeprazole for treating AP could increase the cure rate[relative risk （RR）= 1.32,95% 95% confidence interval（CI） 1.20, 1.44, P 〈 0.000 01], decrease the incidence of complications （RR =0. 16, 95% CI 0. 09, 0. 30, P 〈 0. 000 01） and the mortality rate（ RR =0. 36,95% CI O. 17, 0.80, P =0. 01）; could shorten the average hospitalization time; in addition, which could shorten the time of abdominal pain and distension （MD=- 1.63,95% CI-2.08,- 1. 18, P 〈 0. 000 01） and the recovery time of blood amylase （MD =-3.20, 95% C1-3.76,-2.64, P 〈 0. 000 01）. Conclusion On the basis of the conventional therapy, adding somatostatin combined with omeprazole has more significant effect in treating AP than the conventional therapy. However, the lower quality of included RCTs in this systematic review could influence the argumentation intensity, so more high quality double-blind RCTs are expected to provide high quality evidence.

关 键 词：生长抑素 奥美拉唑 质子泵抑制剂 胰腺炎 系统评价 

分 类 号：R969.4[医药卫生—药理学] R982[医药卫生—药学]