宣肺通腑法治疗脓毒症有效性与安全性的系统评价和Meta分析  

Systemic evaluation and meta-analysis of the efficacy and safety of Xuanfei Tongfu method in the treatment of sepsis

作　　者：史阳 张嘉雯 贺园莉 李猛[1,2] SHI Yang;ZHANG Jia-wen;HE Yuan-li;LI Meng(Shaanxi University of Traditional Chinese Medicine,Xianyang,712046,China;Shaanxi Provincial Hospital of Traditional Chinese Medicine,Xi’an,710004,China)

机构地区：[1]陕西中医药大学,陕西咸阳712046 [2]陕西省中医医院肺病科,陕西西安710004

出　　处：《海南医学院学报》2021年第6期460-466,共7页Journal of Hainan Medical University

基　　金：陕西省科技厅重点研发计划(2017ZDXM-SF-109)。

摘　　要：目的:评价宣肺通腑法治疗脓毒症的有效性与安全性。方法:计算机检索PubMed、Medline、Cochrane图书馆、中国知网、维普数据库、万方数据库截止2019年12月发表的关于宣肺通腑法治疗脓毒症的有效性与安全性文献,采用RevMan 5.3软件对符合纳排标准的相关文献进行系统评价,分析宣肺通腑法对胃肠道功能、胃肠道不良反应、28 d病死率等指标的影响。结果:共纳入15项临床随机对照试验(RCT),共计984名患者。Meta分析结果显示,宣肺通腑类方药联合西医治疗可改善肠道功能。宣肺通腑类方药可减少胃肠道不良反应,差异无统计学意义(P>0.05)。宣肺通腑方药在降低28 d病死率[RR=0.64,95%CI(0.42,0.99),P=0.04],减少APACHEⅡ积分[SMD=−0.90,95%CI(−1.49,−0.31),P=0.0003],降低IL-6[SMD=−0.36,95%CI(−0.62,−0.1),P=0.007],提高IL-10方面优于常规治疗对照组,差异有统计学意义(P<0.05)。结论:宣肺通腑法可以增强胃肠道功能,减少胃肠道不良反应,改善脓毒症患者预后,其可能是通过调节机体免疫炎性反应实现的。Objective:To evaluate the efficacy and safety of XuanFei TongFu method in the treatment of sepsis.Methods:The relevant literatures on the treatment of sepsis by Xuanfei Tongfu method,published by PubMed,Medline and the Cochrane library,CNKI,WEIPU Database and WANFANG Database till December 2019 were searched.Revman 5.3 was used to analyze the relevant literatures that met the inclusion and exclusion criteria,and to evaluate the influence of Xuanfei Tongfu method on gastrointestinal function,adverse reactions of gastrointestinal,28 day mortality.Results:A total of 17 randomized controlled clinical trials(RCTS)involving totally 984 patients were included.Xuanfei Tongfu decoction combined with the control group can im‑prove intestinal function.Xuanfei Tongfu decoction can reduce gastrointestinal adverse reactions,but there is no statistical significance,and reducing mortality of 28 days(RR=0.64,95%CI(0.42,0.99),P=0.04),reducing the APACHEⅡ[SMD=−0.90,95%CI(−1.49,−0.31),P=0.0003],reducing of Il-6[SMD=−0.36,95%CI(−0.62,−0.1),P=0.007],and improving IL-10 were all better than the control group,the difference was statistically significant.Conclusions:The method of Xuanfei Tongfu can enhance the gastrointestinal function,reduce the gastrointestinal adverse reactions,and improve the prognosis of sepsis patients,which may be achieved by regulating the body's immune inflammatory response.

关 键 词：宣肺通腑法 脓毒症 有效性 安全性 META分析 

分 类 号：R278[医药卫生—中医学]