白眉蛇毒血凝酶治疗上消化道出血的系统评价  

Hemocoagulase from Agkistrodon Halys( Pallas) in the Treatment of Upper Gastrointestinal Bleeding: Systematic Evaluation

作　　者：高红瑾[1] 王少明[1,2] 庄捷[1] 

机构地区：[1]福建省立医院药学部,福建福州350001 [2]福建医科大学省立临床医学院,福建福州350001

出　　处：《中国医院用药评价与分析》2015年第6期760-764,共5页Evaluation and Analysis of Drug-use in Hospitals of China

摘　　要：目的：评价白眉蛇毒血凝酶治疗上消化道出血的效果和安全性。方法：通过计算机检索中国知网、万方数据知识服务平台、中国生物医学文献服务系统、Pub Med、Ovid SP等收集有关白眉蛇毒血凝酶治疗上消化道出血的随机对照试验。由两名评价员独立对纳入文献进行资料提取、质量评价并交叉核对,而后采用Rev Man 5.2软件进行Meta分析。结果：共纳入文献12篇,共1272例患者。白眉蛇毒血凝酶组患者24、48、72 h内止血率均高于对照组,差异均具有统计学意义（P〈0.05）,无效率低于对照组,差异也具有统计学意义[风险比（RR）=0.28,95%可信区间（95%CI）=0.20-0.38,P〈0.01],不良反应发生率与对照组比较差异无统计学意义[风险差（RD）=0.00,95%CI=-0.02-0.03,P=0.67]。结论：白眉蛇毒血凝酶治疗上消化道出血是安全、有效的,但由于纳入研究的方法质量较低,可能存在发表性偏倚,期待更多高质量的随机双盲对照试验提供高质量的证据。OBJECTIVE：To evaluate the efficacy and safety of hemocoagulase from Agkistrodon halys （ pallas） in the treatment of upper gastrointestinal bleeding.METHODS： The randomized controlled trials （ RCTs） about treating upper gastrointestinal bleeding with hemocoagulase from Agkistrodon halys （ pallas） were collected by searching CNKI, WANFANG DATA, SinoMed, PubMed and OvidSP.The assessment of methodological quality and data extraction of the included studies were performed independently by two reviewers and meta-analysis was conducted using RevMan 5.2 software.RESULTS：A total of 12 studies involving 1 272 patients met the inclusion criteria.The meta-analysis showed that the group treated with hemocoagulase from Agkistrodon halys （ pallas） was better than the control group in hemostatic rate within 24 h, 48 h and 72 h （ P 〈0.05 ） .The ineffective rate between the group treated with hemocoagulase from Agkistrodon halys （pallas） and control group was statistically significant （RR=0.28, 95%CI=0.20 to 0.38 , P〈0.01 ） .There were no significant differences between the two groups in the adverse reaction rate （RD=0.00, 95%CI=-0.02-0.03, P=0.67）.CONCLUSIONS： Hemocoagulase from Agkistrodon halys （pallas） is effective and safe in treating upper gastrointestinal bleeding.With low methodological quality and publication bias of the included trials, it is necessary to perform more hign quality and large scale randomized double blind controlled trials to provide evidences of high quality.

关 键 词：蛇毒液类/治疗应用 胃肠出血/药物疗法 止血药/治疗应用 Meta分析 白眉蛇毒血凝酶 

分 类 号：R973.1[医药卫生—药品] R573.2[医药卫生—药学]