[关键词]
[摘要]
目的 系统评价异甘草酸镁静辅助治疗重症急性胰腺炎(SAP)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)、维普中文期刊全文数据库(VIP)、中国生物医学文献数据库(CBM)、万方数据库、PubMed、EmBase和The Cochrane Library数据库有关常规治疗联合异甘草酸镁(试验组)对比常规治疗(对照组)治疗SAP的随机对照试验(RCTs),检索时间为从建库到2020年10月。提取数据、评价文献质量后,采用RevMan 5.3软件进行Meta分析。结果 最终纳入12篇RCTs和1 161例受试者。Meta分析结果显示:试验组临床有效率[RR=1.23,95% CI=(1.17,1.30),P<0.01]显著大于对照组;试验组CRP水平下降值[SMD=-1.67,95% CI=(-2.41,-0.93),P<0.01]、TNF-α水平下降值[SMD=-1.17,95% CI=(-1.55,-0.78),P<0.01]和IL-6水平下降值[SMD=-1.40,95% CI=(-1.86,-0.94),P<0.01]均显著大于对照组;试验组治疗后ALT水平[SMD=-2.35,95% CI=(-2.90,-1.79),P<0.01]和AST水平[SMD=-1.77,95% CI=(-2.46,-1.08),P<0.01]均显著小于对照组。ADR发生率组间比较无显著性差异[RR=1.49,95% CI=(0.88,2.54),P=0.14]。结论 异甘草酸镁能显著降低SAP患者炎性因子,改善肝肾功能,减少临床体征改善时间,改善早期预后,且安全性好。
[Key word]
[Abstract]
Objective To evaluate the efficacy and safety of magnesium isoglycyrrhizinate in the adjuvant treatment of the patients with severe acute pancreatitis (SAP). Methods Randomized controlled trials (RCTs) about the routine treatment combined with magnesium isoglycyrrhizinate (test group) compared with the routine treatment (control group) in the treatment of SAP was searched in CNKI, Wanfang, VIP, CBM, PubMed EmBase and the Cochrane Library databases from inception to October 2020 by computer. Meta-analysis was performed on the homogeneous study using RevMan 5.3 software after screened the literature, evaluated the quality of included studies. Results A total of 12 RCTs and 1 161 patients were included. The Metaanalysis showed that the test group of the clinical effective rate[RR=1.23, 95%CI=(1.17, 1.30), P < 0.01] was significantly higher than that in the control group; the test group of the decrease values of CRP levels[SMD=1.67, 95%CI=(2.41, 0.93), P < 0.01], TNFα levels[SMD=-1.17, 95%CI=(-1.55, -0.78), P < 0.01] and IL-6 levels[SMD=-1.40, 95%CI=(-1.86, -0.94), P < 0.01] were all significantly higher than those in the control group; after the treatment, the test group of ALT levels[SMD=-2.35, 95%CI=(-2.90, -1.79), P < 0.01] and AST levels[SMD=-1.77, 95%CI=(-2.46, -1.08), P < 0.01] were all significantly lower than those in the control group. There was no significant difference in rate of ADR[RR=1.49, 95%CI=(0.88, 2.54), P =0.14]. Conclusion Magnesium isoglycyrrhizinate can significantly reduce inflammatory factors, improve liver and kidney function, reduce clinical signs to improve the time, improve early prognosis, meanwhile with good safety.
[中图分类号]
R286.5
[基金项目]
衡水市科技计划项目(2019014059Z)