中药灌肠治疗脓毒症急性肾损伤疗效及安全性的系统评价及Meta分析Effectiveness and Safety of Traditional Chinese Medicine Enema in the Treatment of Sepsis Acute Kidney Injury:A Systematic Review and Meta-Analysis
周峰,赵国桢,李博,徐霄龙,刘清泉
摘要(Abstract):
目的 系统评价中药灌肠治疗脓毒症急性肾损伤的疗效及安全性。方法 检索中国知网(CNKI)、万方数据库(Wanfang)、中文科技期刊数据库(VIP)、中国生物医学文献服务系统(SinoMed)、PubMed、Embase与Cochrane Library数据库,纳入中药灌肠治疗脓毒症急性肾损伤的随机对照试验(RCT),使用Cochrane风险偏倚评估工具进行文献质量评价,使用RevMan 5.4.1软件进行数据分析。结果 纳入10篇RCT,共724例患者。Meta分析结果显示,与对照组相比,试验组血肌酐水平降低[MD=-14.38,95%CI(-18.28,-10.47),P <0.01],临床有效率提高[RR=1.20,95%CI(1.11,1.31),P <0.01],APACHEⅡ评分[MD=-3.37,95%CI(-3.68,-3.07),P <0.01]、尿素氮水平[MD=-1.66,95%CI(-2.37,-0.95),P <0.01]、超敏C反应蛋白水平[MD=-1.84,95%CI(-2.09,-1.59),P <0.01]、白细胞介素-6水平[SMD=-1.45,95%CI(-1.73,-1.17),P <0.01]、肿瘤坏死因子-α水平[SMD=-1.43,95%CI(-1.70,-1.16),P <0.01]均降低。只有1篇文献报道了安全性结局指标,试验组与对照组治疗前后谷草转氨酶、谷丙转氨酶无统计学差异。结论 现有证据表明,中药灌肠治疗脓毒症急性肾损伤具有良好临床疗效且基本安全;但本研究纳入文献数量少、质量低,上述结论仍然需要多中心、大样本的RCT研究进一步验证。
关键词(KeyWords): 脓毒症;急性肾损伤;中药灌肠;Meta分析
基金项目(Foundation): 国家中医药多学科交叉创新团队项目(ZYYCXTD-D-202201)
作者(Author): 周峰,赵国桢,李博,徐霄龙,刘清泉
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