大黄牡丹皮汤加味治疗急性阑尾炎的Meta分析  

Systematic Review and Meta-analysis of Dahuang Mudanpi Decoction on Acute Appendicitis

作　　者：邓超胜 张超源 吴晋芳 罗菁[3] 崔韶阳[3] 梁文坚[2] 王曙辉[3] DENG Chaosheng;ZHANG Chaoyuan;WU Jinfang;LUO Jing;CUI Shaoyang;LIANG Wenjian;WANG Shuhui(The Clinical Medicinal College of Acupuncture Moxibustion and Rehabilitation,Guangzhou University of Chinese Medicine,Guangzhou,510006,China;Guangdong Second Traditional Chinese Medicine Hospital,Guangzhou,510095,China;Shenzhen Hospital of Guangzhou University of Chinese Medicine,Shenzhen,518034,China)

机构地区：[1]广州中医药大学针灸康复临床医学院,广东广州510006 [2]广东省第二中医院,广东广州510006 [3]广州中医药大学深圳医院,广东深圳518034

出　　处：《云南中医学院学报》2019年第4期31-38,共8页Journal of Yunnan University of Traditional Chinese Medicine

基　　金：深圳市“医疗卫生三名工程”(SZSM201502044)。

摘　　要：目的系统评价在常规西医治疗基础上联合大黄牡丹皮汤治疗急性阑尾炎的有效性及安全性。方法计算机检索中国知网(CNKI)、中国生物医学文献数据库(CBM)、维普(VIP)、万方(WanFang)数据库中关于大黄牡丹皮汤治疗急性阑尾炎的随机对照实验,检索时间为建库至2019年6月23日,由2名研究者分别独立筛选文献、提取资料并评价纳入文献的偏倚风险,用Revman5.3进行数据分析。结果共纳入15篇文献,1436名患者。Meta分析提示:与对照组相比,实验组能提高临床有效率[RR=1.20,95%CI(1.15,1.25),P<0.00001],减轻患者腹痛症状[RR=-1.65,95%CI(-2.10,-1.20),P<0.00001]及压痛症状持续时间[RR=-2.03,95%CI(-2.75,-1.31),P<0.00001],促使体温尽早恢复正常[RR=-2.14,95%CI(-2.45,-1.83),P<0.00001],降低患者炎症指标,包括白细胞数[RR=-1.58,95%CI(-2.43,-0.73),P<0.0003]、中性粒细胞比值[RR=-4.50,95%CI(-5.95,-3.05),P<0.00001]及血清CRP[RR=-2.17,95%CI(-2.53,-1.81),P<0.00001]。结论在常规西医治疗基础上联合大黄牡丹皮汤治疗急性阑尾炎患者,能进一步提高临床疗效,缩短患者局部(腹痛和压痛症状)及全身(体温)持续时间,降低炎症指标,但由于纳入文献质量参差不齐,上述结论仍需更高质量文献支持。Objective To systematically review the effectiveness and safety of Dahuang Mudanpi Decoction on acute appendicitis.Methods Four Chinese databases(CNKI,CBM,VIP,WanFang)were searched for the study of randomized controlled trials(RCTs)of Dahuang Mudanpi Decoction on acute appendicitis.Two researchers independently screened the literature,extracted effective data,assessed the risk of bias,and analyzed the data by RevMan 5.3 software.Results Eventually fifteen literatures were included containing 1436 patients.The Meta-analysis indicated that compared with control groups,the trail groups could improve the clinical efficacy in acute appendicitis patients[RR=1.20,95%CI(1.15,1.25),P<0.00001],promote the temperature to return to normal[RR=-2.14,95%CI(-2.45,-1.83),P<0.00001],abridge the duration of acute abdominal pain[RR=-1.65,95%CI(-2.10,-1.20),P<0.00001]and tenderness[RR=-2.03,95%CI(-2.75,-1.31),P<0.00001].Meantime,inflammation markers declined,including the white blood cell counts[RR=-1.58,95%CI(-2.43,-0.73),P=0.0003],percentage of neutrophils[RR=-4.50,95%CI(-5.95,-3.05),P<0.00001],high-sensitivity C-reactive protein[RR=-2.17,95%CI(-2.53,-1.81),P<0.00001].Conclusion Dahuang Mudanpi Decoction could further improve clinical efficacy compared with routine treatment alone,abridge the duration of partial(acute abdominal pain and tenderness)and systematic(temperature)symptoms,reduce the inflammation markers.Literature of higher quality is still needed to support the conclusion due to the uneven quality of the literature.

关 键 词：大黄牡丹皮汤 急性阑尾炎 META分析 

分 类 号：R256.39[医药卫生—中医内科学]