兰索拉唑单用与联合奥曲肽在急性上消化道出血中疗效的Meta分析  

Meta analysis on the treatment of acute upper gastrointestinal bleeding with lansoprazole alone and combined with octreotide

作　　者：李芳会 王立惠[2] 

机构地区：[1]西安市东郊第一职工医院内科 [2]西安市华山中心医院内科,陕西西安710043

出　　处：《临床和实验医学杂志》2016年第17期1685-1690,共6页Journal of Clinical and Experimental Medicine

摘　　要：目的采用循证医学的方法,评价兰索拉唑单独使用与联合奥曲肽在急性上消化道出血中的疗效。方法计算机检索Pub Med、EMBASE、the Cochrane Library、维普、万方、CBM、CNKI、Web of Science数据库中有关兰索拉唑联合奥曲肽治疗急性上消化道出血的随机对照试验,检索时间截止于2015年10月。使用循证医学的方法评价纳入文献质量,从兰索拉唑单独治疗(单独组)及兰索拉唑联合奥曲肽(联合组)的止血时间、治疗效果及不良反应三个方面综合评价两组方案各自优劣性。使用Review Manager5.3软件进行Meta分析。结果本研究共纳入8个随机对照试验,总计660例患者。Meta分析结果显示,联合组与单独组在止血时间[OR=-11.03,95%CI(-13.35,-8.72)]、显效[OR=2.30,95%CI(1.61,3.28)]、无效[OR=0.23,95%CI(0.14,0.40)]及总有效率[OR=4.09,95%CI(2.53,6.61)]上的差异具有统计学意义。在有效[OR=0.97,95%CI(0.68,1.37)]及恶心呕吐发生率[OR=1.34,95%CI(0.46,3.92)]上的差异无统计学意义。结论兰索拉唑联合奥曲肽较奥曲肽单独治疗急性上消化道出血时可显著缩短止血时间,提高有效率,同时不会增加恶心呕吐等不良反应的发生率。Objective To evaluate the treatment effect of lansoprazole alone and lansoprazole combined with octreotide in acute upper gastrointestinal bleeding. Methods We searched the database of CBM , CNKI, VIP, WANFANG Data, PubMed, EMBASE , the Cochrane Library and Web of Science for patients who diagnosed acute upper gastrointestinal bleeding and treated with lansoprazole alone and combined with octreotide. The Search deadline was October 2015. The quality of included studies were analyzed using evidence based medicine evaluation criteria. The time to stop bleeding, treatment effect and adverse reactions were measured. Review Manager 5. 3 software were used to conduct meta -analysis. Results Eight randomized controlled trials which involving 660 patients were included. The meta - analysis results showed that combination group versus separate group in stop bleeding time [ OR = - 11.03, 95%CI（ - 13.35, - 8.72） ] , excellence rate [ OR = 2. 30 , 95%CI（1.61, 3.28）] , invalid rate [ OR - 0. 23 , 95 % CO （0. 14 , 0. 40 ） ] and total efficiency rate [ OR - 4. 09, 95 % CI （2.53, 6.61）] were statistically different. While in the effective rate [ OR = 0.97, 95 % CI （0.68, 1.37）] and nausea and vomiting incidence [ OR = 1.34 , 95%CI（0.46, 3.92） ] , the difference was not statistically significant. Conclusion The results of this study showed that lansoprazole combined with octreotide compared with octreotide alone in the treatment of acute upper gastrointestinal bleeding can significantly shorten the bleeding time and improve the efficiency, and does not increase the incidence of nausea, vomiting and other adverse reactions.

关 键 词：上消化道出血 兰索拉唑 达克普隆 奥曲肽 随机对照试验 META分析 

分 类 号：R573.2[医药卫生—消化系统]