摘要
目的评价西医常规治疗基础上中药保留灌肠治疗肝性脑病的疗效。方法计算机检索Cochrane图书馆、Pub Med、EMbase、维普、中国知网、中国生物医学文献数据库和万方数据库中关于西医常规治疗基础上中药保留灌肠(试验组)对比西医常规治疗(对照组)治疗肝性脑病的随机对照试验(RCT),并追溯纳入文献的参考文献,检索时限为各数据库从建库至2013年11月。由2名研究者按照文献纳入和排除标准独立进行文献筛选、资料提取、质量评价并交叉核对后,采用Rev Man 5.1软件进行Meta分析。结果最终纳入26个RCT,共计1 691例患者。根据干预时间的长短进行亚组分析,7 d为1个疗程。Meta分析结果显示:干预时间≤1个疗程,试验组的总有效率高于对照组,两组差异有统计学意义[RR=1.34,95%CI(1.25,1.44),P<0.000 01];干预时间>1个疗程,试验组的总有效率高于对照组,两组差异有统计学意义[RR=1.34,95%CI(1.21,1.48),P<0.000 01]。结论西医常规治疗基础上中药保留灌肠对于治疗肝性脑病有显著疗效。由于纳入分析的研究质量差异较大,因此有必要进行大样本、多中心、随机、双盲的对照试验,以进一步证实其临床疗效。
Objective To evaluate the efficacy of western conventional treatment based on traditional Chinese medicine retention enema on patients with hepatic encephalopathy.Methods Such databases as the Cochrane Library,PubMed,EMbase,VIP,CNKI,CBM and WanFang Database were searched from the inception to November 2013 to collect randomized controlled trials（RCTs） about Western conventional treatment based on traditional Chinese medicine retention enema to treat hepatic encephalopathy,and the references of the included literature were also retrieved.Two reviewers independently screened the literature according to the inclusion and exclusion criteria,extracted the data,and evaluated and cross-checked the methodological quality.Then meta-analysis was conducted using RevMan 5.1 software.Results A total of 26 RCTs involving 1 691 patients were included.The subgroup analyses based on the length of intervention time showed that when the course of treatment intervention was less than one,the overall effective rate of the Chinese herbal retention enema group was higher than that of the control group,with a significant difference[RR=134,95%CI（1.25,1.44）,P〈0.000 01];after more than one course of treatment intervention,the overall effective rate of the Chinese herbal retention enema group was higher than that of the control group,with a significant difference[RR=134,95%CI（1.21,1.48）,P〈0.000 01].Conclusions On the basis of available evidence,the western medicine treatment based on traditional Chinese medicine retention enema for hepatic encephalopathy has a certain effect.However,the heterogeneity among the included studies is large.It is necessary to design multicenter,strictly randomized and doubleblind test controlled trials with large samples to validate these conclusions and to further confirm the clinical curative effect.
出处
《华西医学》
CAS
2015年第4期662-668,共7页
West China Medical Journal
关键词
中药保留灌肠
肝性脑病
META分析
Traditional Chinese medicine enema
Hepatic encephalopathy
Meta-analysis
