中医通腑泄热法治疗脓毒症胃肠功能障碍的系统评价与Meta分析  

Systematic Evaluation and Meta-analysis of TCM Bowel-freeing Method of TongFu XieRe in the Treatment of Gastrointestinal Dysfunction in Sepsis

作　　者：陈剑明[1] 刘清泉[1] 黄坡 连博 陈腾飞[1] 李博[2] 徐霄龙[2] CHEN Jianming;LIU Qingquan;HUANG Po;LIAN Bo;CHEN Tengfei;LI Bo;XU Xiaolong(Beijing Hospital of TCM Affiliated to Capital Medical University,Beijing 100010,China;Beijing Institute of Traditional Chinese Medicine)

机构地区：[1]首都医科大学附属北京中医医院,北京100010 [2]北京市中医研究所

出　　处：《西部中医药》2022年第2期67-73,共7页Western Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(81673934,81973608,62041701);国家“十三五”规划课题(2017ZX10305501);中国博士后面上基金(2019M650774);北京市自然科学基金(7192083);北京市属医院科研培育计划项目(PZ2019009,PZ20221022);首都医科大学校级自然项目(PYZ19170)。

摘　　要：目的:系统评价中医通腑泄热法治疗脓毒症胃肠功能障碍的临床有效性。方法:将预设的关键词在中国学术期刊全文数据库(CNKI)、万方数据库及Cochrane Library和PubMed数据库进行检索。将检索的文献按纳入和排除标准进行筛选,提取筛选后文献的一般资料信息(第一作者、发表年份、病例资料来源、分组例数、治疗方法、结局指标、诊断标准、评价标准等),再应用Cochrane协作网提供的Rev Man 5.3软件对文献关键的结局指标按二分类变量或连续变量进行统计分析。结果:西医对症治疗联合中医通腑泄热法治疗脓毒症胃肠功能障碍(中医腑实证)可降低7天死亡率和28天死亡率;改善患者的胃肠功能障碍评分、急性生理与慢性健康Ⅱ评分(acute physiology and chronic health evaluation,APACHEⅡ);降低患者继发多脏器衰竭病例;提高有效率,降低患者血清降钙素原水平、C反应蛋白水平、白细胞总数水平,且优于单纯西医对症治疗组(P<0.01)。结论:西医对症治疗联合中医通腑泄热法治疗脓毒症胃肠功能障碍(中医腑实证)具有一定的优势。鉴于本研究纳入的原始研究质量偏低,尚待更多高质量研究进行证实。Objective:To systematically evaluate the clinical effectiveness of traditional Chinese medicine bowel-freeing method in the treatment of gastrointestinal dysfunction in sepsis patients.Methods:By searching in CNKI,Wanfang,Cochrane library and PubMed databases,the literatures were screened according to the inclusion and exclusion criteria.General information containing the first author,publication years,the source of case data,the number of grouped cases,therapeutic methods,outcome indexes,diagnostic standards,evaluation criteria and others were extracted from the screened literatures,Rev Man 5.3 software provided by Cochrane collaboration network was used to statistically analyze the key outcome indicators of the literature according to binary variables or continuous variables.Results:Symptomatic therapy of western medicine combined with traditional Chinese medicine bowel-freeing method could decrease 7-day and 28-day mortality rate in the treatment for gastrointestinal dysfunction in sepsis patients(TCM Fu-organ excess pattern);it could improve the scores of gastrointestinal dysfunction and APACHEII;reduce the cases of secondary mutiple organ failure and lift the effective rate;lower the levels of serum procalcitonin,CRP and total leukocyte count,and the effects superior to these of only symptomatic therapy of western medicine(P<0.01).Conclusion:Symptomatic therapy of western medicine jointed with traditional Chinese medicine bowel-freeing method possess the certain advantages in treating gastrointestinal dysfunction in sepsis patients.In view of the low quality of the original studies included in this study,it needs to be confirmed by more high-quality studies.

关 键 词：脓毒症 中医腑实证 通腑法 疗效 系统评价 META分析 

分 类 号：R714.626[医药卫生—妇产科学]