中药灌肠联合芒硝外敷治疗急性胰腺炎临床疗效的Meta分析

Clinical efficacy of traditional Chinese medicine enema combined with mirabilite external application in treating acute pancreatitis: a Meta-analysis

关键词:  急性胰腺炎  大黄  承气汤类方  中药灌肠  芒硝外敷  中医外治法  Meta分析

Key words:  acute pancreatitis  rhubarb  Chengqi Decoction Categorized Formula  traditional Chinese medicine enema  mirabilite external application  tradition Chinese medicine external treatment  Meta-analysis

摘要:

[目的] 系统评价中药灌肠联合芒硝外敷治疗急性胰腺炎（AP）的临床疗效，为临床治疗AP提供循证参考。[方法] 系统检索PubMed、EMBase、The Cochrane Library、中国生物医学文献数据库（CBM）、万方数据库、中国知网数据库和维普网，筛选中药保留灌肠联合芒硝外敷治疗AP的随机对照研究，检索时间为各数据库建库至2022年8月1日。由两位研究者按照事先制定的纳入和排除标准筛选文献，提取资料，并进行质量评价，采用RevMan 5.3软件进行Meta分析。[结果] 纳入11篇文献，共计721例，其中试验组361例，对照组360例。Meta分析结果显示，中药保留灌肠联合芒硝外敷可缩短肠道功能恢复时间及腹部症状缓解时间[MD=-1.68，95% CI（-2.22，-1.14），P<0.000 01；MD=-2.30，95% CI（-3.69，-0.91），P=0.001]，降低急性生理与慢性健康状况评分（APACHEⅡ评分）与C反应蛋白（CRP）水平[MD=-3.88，95% CI（-5.39，-2.37），P<0.000 01；MD=-10.39，95% CI（-13.35，-7.43），P<0.000 01]，提高临床治疗有效率[RR=1.22，95% CI（1.08，1.37），P=0.001]。[结论] 中药灌肠联合芒硝外敷对提高临床疗效及防止疾病进展有一定意义，但仍需高质量临床试验进一步证实。

Abstract:

[Objective] To systematically evaluate the clinical efficacy of traditional Chinese medicine enema and mirabilite external application in treating acute pancreatitis(AP), and to provide evidence-based reference for the treatment of AP. [Methods] The databases such as PubMed, EMBase, the Cochrane Library, CBM, WanFang, CNKI and VIP were searched to collect relevant randomized controlled trials from the date of their establishment to August 1st, 2022. Then the studies were screened according to the pre-defined inclusion and exclusion criteria, the data was extracted, the quality of the included studies was methodological evaluated, and Meta-analyses were performed by using RevMan 5.3 software. [Results] A total of 11 articles and 721 patients were included. Meta-analysis results shows that traditional Chinese medicine enema combined with mirabilite external application can shorten the recovery time of intestinal function and abdominal symptom relief time [MD=-1.68, 95%CI(-2.22, -1.14), P<0.000 01;MD=-2.30, 95%CI(-3.69, -0.91), P=0.001], reduce the APACHEⅡscore and CRP level [MD=-3.88, 95%CI(-5.39, -2.37), P<0.000 01;MD=-10.39, 95%CI(-13.35, -7.43), P<0.000 01], and improve the efficiency of clinical treatment [RR=1.22, 95%CI(1.08, 1.37), P=0.001]. [Conclusion] On the basis of conventional Western medicine treatment, AP patients supplemented by Chinese medicine enema combined with mirabilite external application can promote intestinal function recovery, reduce inflammatory reaction and relieve abdominal symptoms, which is helpful to improve the clinical efficacy and prevent the disease progression, but it still needs high-quality clinical trials.