摘要
目的系统性评价重组人生长激素联合谷氨酰胺治疗严重烧伤患者的临床疗效。方法计算机检索中国知网、维普、万方数据库、中国生物医学文献数据库、PubMed和Cochrane library,各数据库检索年限均为从建库至2018年6月,查找并纳入有关重组人生长激素联合谷氨酰胺治疗严重烧伤患者临床疗效的随机对照试验,Jadad评分标准评价纳入文献质量后使用RevMan5.3软件进行Meta分析。结果共纳入随机对照临床试验文献7篇,其中对照组共222例患者均给予常规抗烧伤休克、液体复苏、抗感染、营养支持等基础治疗,试验组共224例患者在上述常规治疗手段基础上给予重组人生长激素联合谷氨酰胺治疗方案。Meta分析结果显示,与对照组比较,试验组治疗后血清白蛋白水平升高(SMD=1.67,95%CI:1.13~2.22,P<0.00001),IgA水平升高(SMD=0.96,95%CI:0.952^-1.40,P<0.0001);IgM水平未明显升高(SMD=0.20,95%CI:-0.01~0.42,P=0.06),IgG水平升高(SMD=1.30,95%CI:0.93~1.66,P<0.00001),创面愈合率升高(SMD=3.64,95%CI:2.23~5.04,P<0.00001),创面愈合时间缩短(SMD=-1.29,95%CI:-1.55^-1.04,P<0.00001),住院时间缩短(SMD=-2.04,95%CI:-2.70^-1.38,P<0.00001)。结论重组人生长激素联合谷氨酰胺治疗严重烧伤患者有助于改善创面愈合率,提高血清白蛋白、IgA、IgG等免疫球蛋白水平,缩短创面愈合时间和住院时间,临床疗效确切。
Objective To systematically evaluate the clinical efficacy of recombinant human growth hormone combined with glutamine in the treatment of patients with severe burns.Methods The computer searched China HowNet,Weipu,Wanfang Database,Chinese Biomedical Literature Database,PubMed and Cochrane library.The search period of each database was from the establishment of the database to June 2018.A randomized controlled trial of clinical efficacy in the treatment of severe burn patients.The Jadad score was used to evaluate the quality of the literature.Meta-analysis was performed using RevMan5.3 software.Results A total of 7 randomized controlled clinical trial literatures were included,of which 222 patients in the control group were given conventional anti-burn shock,fluid resuscitation,anti-infection,nutrition support and other basic treatments,and 224 patients in the test group were given on the basis of the above conventional treatment Recombinant human growth hormone combined with glutamine.Meta analysis results showed that compared with the control group,serum albumin levels in the experimental group increased after treatment(SMD=1.67,95%CI:1.13~2.22,P<0.00001),and IgA levels increased(SMD=0.96,95%CI:0.952^-1.40,P<0.0001);IgM level did not increase significantly(SMD=0.20,95%CI:-0.01~0.42,P=0.06),IgG level increased(SMD=1.30,95%CI:0.93~1.66,P<0.00001),wound healing rate increased(SMD=3.64,95%CI:2.23~5.04,P<0.00001),wound healing time shortened(SMD=-1.29,95%CI:-1.55^-1.04,P<0.00001),shortened the length of hospital stay(SMD=-2.04,95%CI:-2.70^-1.38,P<0.00001).Conclusion Recombinant human growth hormone combined with glutamine can improve the wound healing rate,increase the levels of serum albumin,IgA,IgG and other immunoglobulins,shorten the wound healing time and hospital stay,and the clinical effect is exact.
作者
彭德明
PENG De-ming(Department of Pharmacy,the Affiliated Hospital of Nankai University/Tianjin Fourth Hospital,Tianjin 300222,China)
出处
《医学信息》
2020年第7期76-81,共6页
Journal of Medical Information
关键词
重组人生长激素
谷氨酰胺
严重烧伤
营养支持
免疫功能
Recombinant human growth hormone
Glutamine
Severe burns
Nutritional support
Immune function
