中医药联合常规西药对脓毒症胃肠功能障碍疗效的Meta分析  

Meta-analysis of the Efficacy of Combined Traditional Chinese Medicine and Conventional Western Medicine for Gastrointestinal Dysfunction in Sepsis

作　　者：刘茜[1] 卢伟 邵旭鹏 谢娜 陆佳敏 张铎 刘荣飞 于子洲 范开亮[1] Liu Qian;Lu Wei;Shao Xupeng;Xie Na;Lu Jiamin;Zhang Duo;Liu Rongfei;Yu Zizhou;Fan Kailiang(The Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Shandong,Jinan 250014,China)

机构地区：[1]山东中医药大学附属医院,山东济南250014 [2]山东中医药大学,山东济南250355

出　　处：《中国中医急症》2024年第9期1512-1518,1541,共8页Journal of Emergency in Traditional Chinese Medicine

基　　金：国家自然科学基金项目(82374242,82074227);山东省医药卫生科技发展计划项目(202117010252)。

摘　　要：目的采用Meta分析对中医药与常规西药联合治疗脓毒症胃肠功能障碍临床疗效和安全性进行评价。方法计算机检索CBM、VIP、WanFang、CNKI及PubMed数据库2020年1月1日至2024年5月1日中医药治疗脓毒症胃肠功能障碍的临床随机对照试验。依据纳入与排除标准,对文献仔细筛选,提取相应数据,采用RevMan5.4及Stata16.0对数据进行统计分析。结果36项研究共纳入3279例脓毒症胃肠功能障碍患者,其中观察组1644例,对照组1635例。研究结果提示:相对于单纯常规西药治疗而言,联合中药可显著提高治疗疗效。临床总有效率[OR=3.66,95%CI(2.87,4.67),Z=10.43,P<0.00001]、改善胃肠功能障碍评分[MD=-0.60,95%CI(-0.63,-0.56),Z=32.44,P<0.00001]、APACHEⅡ评分[MD=-3.90,95%CI(-4.10,-3.71),Z=40.02,P<0.00001];降低白细胞计数[MD=-2.20,95%CI(-2.33,-2.08),Z=35.38,P<0.00001]、C反应蛋白[MD=-18.56,95%CI(-18.86,-18.26),Z=122.56,P<0.00001]、降钙素[SMD=-1.60,95%CI(-1.76,-1.44),Z=19.11,P<0.00001];减轻28 d死亡率[OR=0.43,95%CI(0.26,0.72),Z=3.26,P=0.001];安全性良好。结论中医药与常规西药合用治疗脓毒症胃肠功能障碍患者疗效明显优于常规西药,安全性好。Objective:To evaluate the clinical efficacy and safety of combined traditional Chinese medicine(TCM)and conventional western medicine(CWM)for gastrointestinal dysfunction in sepsis through a meta-analysis.Methods:Computerized searches were conducted in the CBM,VIP,WanFang,CNKI,and PubMed databases from January 1,2020,to May 1,2024,for randomized controlled trials(RCTs)involving TCM treatment for gastrointestinal dysfunction in sepsis.According to inclusion and exclusion criteria,relevant data were extracted and performed statistical analysis using RevMan 5.4 and Stata 16.0 software.Results:A total of 36 studies involving 3279 patients with gastrointestinal dysfunction in sepsis were included,with 1644 patients in the observation group and 1635 cases in the control group.The results suggested that compared to CWM alone,the combination of TCM and CWM significantly improved treatment efficacy[OR=3.66,95%CI(2.87,4.67),Z=10.43,P<0.00001],improved gastrointestinal function[MD=-0.60,95%CI(-0.63,-0.56),Z=32.44,P<0.00001],and reduced APACHEⅡscores[MD=-3.90,95%CI(-4.10,-3.71),Z=40.02,P<0.00001].It also decreased white blood cell count[MD=-2.20,95%CI(-2.33,-2.08),Z=35.38,P<0.00001],C-reactive protein levels[MD=-18.56,95%CI(-18.86,-18.26),Z=122.56,P<0.00001],and calcitonin levels[SMD=-1.60,95%CI(-1.76,-1.44),Z=19.11,P<0.00001];and reduced 28 day mortality rates[OR=0.43,95%CI(0.26,0.72),Z=3.26,P=0.001].The safety was good.Conclusion:The combined use of TCM and CWM for treating gastrointestinal dysfunction in sepsis demonstrated significantly better efficacy than CWM alone,with good safety.

关 键 词：脓毒症 胃肠功能障碍 中西医结合 META分析 随机对照试验 

分 类 号：R631[医药卫生—外科学]