目的 应用网状Meta分析的方法评价不同中药注射液联合常规治疗重症急性胰腺炎（severe acute pancreatitis，SAP）的疗效及安全性。方法 计算机检索PubMed、EMbase、Cochrane、Web of Science、中国知网（CNKI）、万方（Wanfang）、维普（VIP）等数据库，检索时间为各数据库建库至2021年9月1日。根据纳入、排除标准，由2名研究者独立进行文献检索，按照Cochrane协作网制定的Cochrane风险偏倚评估工具进行质量评价，应用Stata 14.0软件进行统计分析。结果 最终纳49项临床随机对照试验（randomized controlled trials，RCTs），涉及10种中药注射液，3820例患者。网状Meta分析结果显示，临床疗效排序从优到劣为参麦注射液、丹参川芎嗪注射液、参芎葡萄糖注射液、血必净注射液、灯盏花素注射液、川芎嗪注射液、丹红注射液、丹参注射液、复方丹参注射液分别联用常规治疗；病死率排序从低到高为丹参川芎嗪注射液、血必净注射液、灯盏花素注射液、参附注射液、复方丹参注射液、丹参注射液、丹红注射液分别联用常规治疗；血淀粉酶恢复时间排序从优到劣为参芎葡萄糖注射液、丹参注射液、丹参川芎嗪注射液、灯盏花素注射液、血必净注射液、参麦注射液、复方丹参注射液分别联用常规治疗；不良反应发生率从低到高为川芎嗪注射液、血必净注射液、复方丹参注射液、丹参川芎嗪注射液、参麦注射液、丹参注射液分别联用常规治疗。结论 在常规治疗基础上联合不同中药注射液可提高SAP的临床疗效，降低病死率，缩短血淀粉酶恢复时间，降低不良反应发生率，但由于纳入研究的局限性，方法学质量普遍不高，应谨慎选择用药，未来仍需开展多中心、大样本、高质量的RCTs予以验证。

Objective To evaluate the efficacy and safety of different traditional Chinese medicine injections combined with conventional treatments for severe acute pancreatitis (SAP) by the method of network Meta-analysis. Methods PubMed, EMbase, Cochrane, Web of Science, CNKI, Wanfang, VIP database were searched by computer, the search time was from the establishment of each database to September 1, 2021. According to the inclusion and exclusion criteria, two researchers conducted independent literature searches, followed the Cochrane risk bias assessment tool developed by the Cochrane Collaboration for quality evaluation, and applied Stata 14.0 software for statistical analysis. Results In the end, 49 randomized controlled trials (RCTs) were included, involving 10 kinds of traditional Chinese medicine injections and 3820 patients. The results of the network Meta-analysis showed that the clinical efficacy was ranked from best to worst:Shenmai Injection (参麦注射液), Danshen Ligustrazine Injection (丹参川芎嗪注射液), Shenxiong Glucose Injection (参芎葡萄糖注射液), Xuebijing Injection (血必净注射液), Breviscapine Injection (灯盏花素注射液), Ligustrazine Injection (川芎嗪注射液), Danhong Injection (丹红注射液), Danshen Injection (丹参注射液), Compound Danshen Injection (复方丹参注射液) combined with conventional treatment respectively; The case fatality rate was ranked from low to high:Danshen Ligustrazine injection, Xuebijing Injection, Breviscapine Injection, Shenfu Injection (参附注射液), Compound Danshen Injection, Danshen Injection, Danhong Injection combined with conventional treatment respectively; Blood amylase recovery time was ranked sorted from best to worst:Shenxiong Glucose Injection, Danshen Injection, Danshen Ligustrazine Injection, Breviscapine Injection, Xuebijing Injection, Shenmai Injection, Compound Danshen Injection combined with conventional treatment respectively; The incidence of adverse reactions was ranked from low to high:Ligustrazine Injection, Xuebijing Injection, Compound Danshen Injection, Danshen Ligustrazine Injection, Shenmai Injection, Danshen Injection combined with conventional treatment respectively. Conclusion Combining with different traditional Chinese medicine injections on the basis of conventional treatment can improve the clinical efficacy of SAP, reduce the case fatality rate, shorten the recovery time of blood amylase, and reduce the incidence of adverse reactions. However, due to the limitations of the included studies, the methodological quality was generally not high and should be choose drugs carefully, and multi-center, large-sample, high-quality RCTs are still needed for verification in the future.

R285.64

国家中医临床研究基地建设项目（国中医药办科技函[2018]18）；国家中医药管理局第三界国医大师传承工作室及全国名老中医传承工作室建设项目（人社部发[2017]45号）；国家科技部重点研发课题：基于“道术结合”思路与多元融合方法的名老中医经验传承创新研究（2018YFC1704100）；东部地区名老中医学术观点、特色诊疗方法和重大疾病防治经验课题（2018YFC1704102）；河北省自然基金项目（H2019423077）