中药灌肠治疗成人脓毒症的Meta分析  

Meta-analysis of traditional Chinese medicine enema for adult sepsis

作　　者：许梦婷 邓定伟[2] 李健[2] XU Mengting;DENG Dingwei;LI Jian(The Second Clinical Medical College of Guangzhou University of Chinese Medicine,Guangzhou 510405,China;Intensive Care Unit,University City Branch of Guangdong Provincial Hospital of Chinese Medicine,Guangzhou 510060,China)

机构地区：[1]广州中医药大学第二临床医学院,广州510405 [2]广东省中医院大学城分院重症监护室,广州510060

出　　处：《天津中医药》2021年第3期350-356,共7页Tianjin Journal of Traditional Chinese Medicine

基　　金：广东省中医院中医药科学技术研究专项(YN2014PJR203);广东省中医急诊研究重点实验室(2017B030314176)。

摘　　要：[目的]系统评价中药灌肠治疗成人脓毒症的疗效。[方法]计算机检索中英文数据库,包括中国知网(CNKI),中国学术期刊数据库(万方)、中国生物医学文献数据库(SinoMed)、维普中文科技期刊全文数据库(VIP)、Pubmed、Embase。收集中药灌肠治疗成人脓毒症的临床研究文献,并进行资料提取和质量评估,采用RevMan 5.2软件进行Meta分析。[结果]纳入13项前瞻性随机对照研究共955例患者。Meta分析结果显示:与西医常规治疗相比,中药灌肠联合西医常规治疗可提高脓毒症治疗的有效率[RR=1.32,95%CI(1.21,1.44),P<0.00001],降低APACHEⅡ评分[MD=-4.88,95%CI(-5.86,-3.89),P<0.00001]、中医症状积分(分)[SMD=-1.37,95%CI(-1.71,-1.04),P<0.00001]、降钙素原(PCT)[SMD=-2.31,95%CI(-3.41,-1.20),P<0.0001]和C反应蛋白(CRP)[SMD=-1.34,95%CI(-2.24,-0.45),P=0.003],差异有统计学意义。但在降低白细胞计数(WBC)方面,两组差异无统计学意义[SMD=-0.67,95%CI(-1.89,0.55),P=0.28,P>0.05]。[结论]中药灌肠可提高成人脓毒症治疗有效率,降低APACHEⅡ评分、中医症状积分(分)及炎症反应。由于各种方法学问题及文献质量较低,尚需更大样本量、更高质量的研究予以验证。[Objective] To systematically evaluate the efficacy of traditional Chinese medicine(TCM) enema in the treatment of adult sepsis. [Methods] Chinese and English databases were searched by computer,including CNKI,Wanfang,SinoMed,VIP,Pubmed,Embase. Clinical literatures on the treatment of adult sepsis with traditional Chinese medicine enema were collected. After extracting data and quality evaluation,the data were meta-analyzed by Revman 5.2 software. [Results] The 13 prospective randomized controlled studies involving 955 patients of sepsis were included. As the Meta analysis showed,compared with routine treatment,traditional Chinese medicine enema combined with western medicine conventional treatment can improve the effective rate of sepsis treatment [ RR =1.32,95%CI(1.21,1.44),P<0.000 01],lower APACHE Ⅱ scores [MD=-4.88,95%CI(-5.86,-3.89),P<0.000 01],TCM syndrome score [SMD=-1.37,95%CI(-1.71,-1.04),P<0.000 01],PCT [SMD=-2.31,95%CI(-3.41,-1.20),P<0.000 1],and CRP[SMD=-1.34,95%CI(-2.24,-0.45),P=0.003],the difference is statistically significant. However,there was no significant difference between two groups in reducing WBC [SMD=-0.67,95%CI(-1.89,0.55),P=0.28]. [Conclusion] Traditional Chinese medicine enema can improve the effective rate of adult sepsis treatment,and reduce APACHE Ⅱ score,TCM syndrome score and inflammatory reaction. Due to various methodological problems and low literature quality,it needs to be verified by studies with larger sample size and higher quality.

关 键 词：中药灌肠 脓毒症 META分析 

分 类 号：R631.1[医药卫生—外科学]