摘要
目的评价血必净联合乌司他丁治疗急性胰腺炎的疗效。方法检索Pubmed、Embase、CENTRAL、中国生物医学文献数据库（CBM）、中国知网（CNKI）、Cochrane临床试验数据库和万方等中英文数据库有关血必净联合乌司他丁治疗急性胰腺炎的随机对照试验（RCT），在客观评价文献质量后提取资料，采用RevMan5．0进行Meta分析，对腹痛缓解时间，血淀粉酶恢复正常时间、白细胞恢复正常时间，IL-6、IL-8、TNF-α等炎性因子水平，总治疗有效率等方面进行评价。结果共纳入11篇文献，共893位患者。Meta分析结果显示：研究组在腹痛缓解时间[加权均数差（WMD）=-1．71，95％CI：-2．21，-1．21，P〈0．01]、血淀粉酶恢复时间（WMD=-1．82，95％CI：-2．39，-1．25，P〈0．01）、白细胞恢复时间（WMD=-2．75，95％CI：-3．19，-2．31，P〈0．01）和住院时间（WMD=-5．99，95％CI：-7．73，-4．26，P〈0．01）方面效果均优于对照组；与对照组相比，研究组在治疗后第7天的IL-6[标准化均数差（SMD）=-1．09，95％CI：-2．66，0．48，P=0．17]、IL-8（SMD=-1．02，95％CI：-1．66，-0．38，P〈0．01）、TNF-α（SMD=-1．10，95％CI：-1．68，-0．53，P〈0．01）等炎性因子的水平均明显降低；研究组总有效率高于对照组（RR=1．16，95％CI：1．07，1．25，P=0．0002）。结论血必净联合乌司他丁治疗急性胰腺炎较传统基础治疗或单用乌司他丁更为有效，但限于所纳入的文献质量不高，需要更多随机、双盲、大型、多中心的临床研究数据来证实。
Objevtive To investigate the efficacy of Xuebijing injection combined with Ulinastatin for acute pancreatitis. Methods Databases were searched, like Pubmed, Embase, Cochrane Central Register of Controlled Trials （CENTRAL）, China Biology Medicine disc （CBM）, China National Knowledge Infrastructure （CNKI）, Cochrane library, and Wangfang for randomized controlled trial （RCT） about the treatment of Xuebijing injection combined with Ulinastatin for acute pancreatitis. After evaluating the quality of literatures objectively, data were analyzed by RevMan 5.0 software, we evaluated abdominal pain relief time, recovery time of blood amylase, recovery time of white blood cell （WBC）, concentration of interleu- kin （IL）-6, IL-8, tumor necrosis factor α （TNF-α） and total effective rate. Results Eleven studies and 893 patients were accepted into this article. Meta-analysis showed that abdominal pain relief time [ weighted mean difference （WMD） = - 1.71,95% CI： -2. 21, - 1.21 ,P 〈0. 01 ], recovery time of blood amylase （WMD = - 1.82,95% CI： -2. 39, - 1.25 ,P 〈0. 01）, recovery time ofWBC （WMD = -2.75,95% CI： - 3. 19, - 2. 31,P 〈 0. 01 ）, and hospital stay time （ WMD = - 5.99,95% CI： - 7.73, - 4. 26,P 〈 0. 01 ） in experimental group was better than control group. Compared to control group, on the seventh day after treatment, inflammatory cytokines, including IL-6 [ standardized mean difference （SMD） = - 1.09,95% CI： -2.66,0.48,P=0. 17], IL-8 （SMD = -1.02,95% CI： -1.66, -0. 38, P〈0.01）, and TNF-α （ SMD = - 1.10,95% CI： - 1.68, - 0. 53, P 〈 0.01 ） were lower. In experimental group, total effective rate was better than the control group （ RR = 1.16,95% C1：1.07,1.25,P = 0. 0002）. Conehmions Xue- bijing injection combined with Ulinastatin for acute pancreatitis was more effective than traditional basal treatment or using Ulinastatin alone. However, the literature quality were mediocre, we need more large, random, double blind, and polyeentric clinical study to prove further.
作者
马维江
尹剑辉
张力君
徐林
罗世璧
宋怀旭
Ma Weijiang Yin Jianhui Zhang Lijun Xu Lin Luo Shibi Song Huaixu(Second College of Clinical Medicine, Ktmming Medical University, Kunming 650500, China Department of General Surgery, Kunming First People＇ Hospital/Can Mei Affiliated Hospital of Kun- ming Medical University, Kunming 650011, China)
出处
《中国医师杂志》
CAS
2017年第1期60-65,共6页
Journal of Chinese Physician
作者简介
通信作者：尹剑辉，Email：1551389142@qq．com
