于辉,汪月奔,甄军海,操蓓蓓,张菊明

• 1:新疆维吾尔自治区阿克苏地区第一人民医院
• 2:浙江医院
• 3:浙江中医药大学

摘要(Abstract)：

目的系统评价参附注射液对脓毒症的临床疗效,为临床提供循证参考。方法计算机检索Pubmed、万方电子资源网、中国知网(CNKI)、维普(VIP),收集采用参附注射液治疗脓毒症为干预措施的临床随机对照试验。提取资料和对最终纳入的文献进行改良的Jadad方法学质量评价后,采用Revman 5.3软件对数据进行Meta分析。结果共纳入17篇随机对照研究,包括英文文献1篇,中文文献16篇,共1 155例脓毒症患者,其中参附组589例患者,对照组566例患者。Meta分析结果显示:参附组28 d病死率低于对照组患者,差异具有统计学意义[RR=0.71,95%CI(0.61,0.83),P <0.0001];参附组ICU住院时间短于对照组[MD=-1.06,95%CI(-1.08,-0.32),P=0.005];治疗后,参附组乳酸水平低于对照组[MD=-1.07,95%CI(-1.74,-0.40),P=0.002];对参附治疗后不同时间点的急性生理学与慢性健康评价Ⅱ(APACHEⅡ评分)进行亚组分析,发现参附组在不同时间点均比对照组有更低的APACHEⅡ评分,24 h:[MD=-2.64,95%CI (-4.77,-0.51),P=0.02]。48 h:[MD=-3.42,95%CI(-4.68,-2.16),P <0.00001]。7 d:[MD=-1.27,95%CI(-2.36,-0.18),P=0.02]。14 d:[MD=-4.89,95%CI(-5.85,-3.93),P <0.00001]。结论根据目前已有的研究,采用参附注射液治疗脓毒症能够降低患者28 d病死率、缩短ICU住院时间、降低血乳酸水平、降低APACHEⅡ评分,改善脓毒症患者预后,但是由于大多数研究质量偏低,需更多高质量的临床随机对照研究进一步证实参附注射液治疗脓毒症的疗效。

关键词(KeyWords)： 参附注射液;脓毒症;脓毒性休克;Meta分析

Abstract:

Keywords:

基金项目(Foundation): 浙江省中医药科技计划项目(2019ZB004)

作者(Author): 于辉,汪月奔,甄军海,操蓓蓓,张菊明

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