摘要
目的系统评价升降散联合西医常规治疗脓毒症的有效性和安全性。方法计算机检索中国学术期刊全文数据库(CNKI)、万方数据知识服务平台(Wanfang Data)、维普中文期刊全文数据库(VIP)、PubMed、Cochrane Library、Embase、Web of Science数据库中升降散治疗脓毒症的随机对照试验(RCT),借助RevMan 5.4软件进行Meta分析。结果共纳入13项RCTs,共720例患者。Meta分析结果表明,试验组(加用升降散)与对照组(西医常规治疗)比较,可提高中医证候疗效[OR=7.04,95%CI(2.85,17.35),P<0.00001],降低中医证候积分[MD=-1.50,95%CI(-1.97,-1.04),P<0.00001]、急性生理与慢性健康评分[MD=-2.56,95%CI(-3.64,-1.49),P<0.00001]、白细胞计数[MD=-1.57,95%CI(-2.14,-1.00),P<0.00001]、C反应蛋白水平[MD=-10.01,95%CI(-15.51,-4.52),P=0.0004],肿瘤坏死因子-α水平[MD=-7.41,95%CI(-13.22,-1.61),P=0.01]、白细胞介素-6水平[MD=-7.71,95%CI(-13.92,-1.50),P=0.01],表明升降散在改善症状和降低炎症方面有显著优势;在安全性方面,两组比较无统计学差异。结论升降散治疗脓毒症的疗效显著,可降低炎症反应,且安全性较高,适用于临床联合用药。
Objective To systematically evaluate the efficacy and safety of Shengjiang Powder combined with conventional western medicine in the treatment of sepsis.Methods Databases such as CNKI,Wanfang Data,VIP,PubMed,Cochrane Library,Embase,and Web of Science were searched by computer for the randomized controlled trial(RCT) of Shengjiang Powder in the treatment of sepsis,the data was analyzed with RevMan 5.4 software.Results A total of 13 RCTs were included,including 720 patients.Metaanalysis results showed that adding to Shengjiang Powder conventional western medicine treatment improved curative effect of traditional Chinese medicine(TCM) syndrome [OR = 7.04,95%CI(2.85,17.35),P<0.000 01],reduced the TCM syndrome score [MD =-1.50,95%CI(-1.97,-1.04),P<0.000 01],acute physiology and chronic health score [MD =-2.56,95%CI(-3.64,-1.49),P<0.000 01],WBC count [MD =-1.57,95%CI(-2.14,-1.00),P<0.000 01],C-reactive protein level [MD =-10.01,95%CI(-15.51,-4.52),P = 0.000 4],tumor necrosis factor-α level [MD =-7.41,95%CI(-13.22,-1.61),P = 0.01],interleukin-6 level [MD =-7.71,95%CI(-13.92,-1.50),P = 0.01],indicators are statistically significant,indicating that Shengjiang Powder has significant advantages in improving symptoms and reducing inflammation.There was no statistical difference in safety between the two groups.Conclusion Shengjiang Powder is effective in the treatment of sepsis,which can reduce the inflammatory reaction of sepsis and has high safety,so it is suitable for clinical combined use.
作者
李修齐
谢云雪
赵启亮
刘旻
LI Xiuqi;XIE Yunxue;ZHAO Qiliang;LIU Min(Frist Teaching Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300381,China;National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion,Tianjin 300381,China;Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China)
出处
《药物评价研究》
CAS
2023年第7期1559-1568,共10页
Drug Evaluation Research
基金
国家重点研发计划项目(2018YFC1707503)
天津市中医药重点领域科研项目(2021010)
天津市卫生健康委、天津市中医药管理局中医中西医结合科研课题(2021098)。
关键词
升降散
脓毒症
急性生理与慢性健康评分
C反应蛋白
系统评价
Shengjiang Powder
sepsis
acute physiology and chronic health score(APACHE II score)
C-reactive protein(CRP)
system evaluation
作者简介
第一作者:李修齐(1998-),硕士在读,研究方向为感染性疾病、呼吸系统疾病临床及基础。E-mail:1253839510@qq.com;通信作者:刘旻(1973-),主任医师,博士生导师,研究方向为感染性疾病、呼吸系统疾病的临床及基础。E-mail:liumintcm@163.com。
