中药治疗脓毒症的疗效：一项系统评价与Meta分析
Efficacy of traditional Chinese medicine on sepsis: a systematic review and Meta-Analysis.
作者信息
Liang Xiao, Zhou Miao, Ge Xin-Yu, Li Cheng-Bao, Fang Shang-Ping, Tang Ling, Shao Dong-Hua, Xu Guo
机构信息
Department of Anesthesiology, Affiliated People's Hospital of Jiangsu University Jiangsu, China.
Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical College, Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, Xuzhou Medical College China.
出版信息
Int J Clin Exp Med. 2015 Nov 15;8(11):20024-34. eCollection 2015.
BACKGROUND
Traditional Chinese medicine (TCM) has been used for treatment of sepsis in China, but results still remain equivocal. To evaluate the safety and efficacy of TCM for sepsis, we conducted this Meta-analysis.
METHODS
Databases searched included randomized controlled trials (RCTs) published in PubMed, Embase and Cochrane Central Register of Controlled Trials (CENTRAL) (up to December 2014). The studies included used routine therapy treating sepsis in the control group and TCM was added on that basis in the experimental group. Methodological quality was assessed by Cochrane criteria for risk of bias.
RESULTS
Ten RCTs with 691 participants were identified and analyzed. In the meta-analysis, TCM plus routine therapy reduced the 28-day mortality compared to routine therapy alone, [RR = 0.67; 95% CI: 0.510.87; P = 0.002]; The decrease in length of ICU-stay [MD = -1.82; 95% CI: -2.60-1.04; P<0.00001]; Acute physiology and chronic health evaluation system (APACHE II) score [MD = -2.95; 95% CI: -3.99-1.91; P<0.00001]; Serum inflammatory factors concentration after treatment [SMD = -0.50; 95% CI:-0.68-0.33; P<0.00001], including TNF-α [SMD = -0.61; 95% CI: -0.85-0.38; P<0.00001] and IL-6 [SMD = -0.40; 95% CI: -0.75-0.04; P = 0.03] in subgroup analysis all had statistical significance.
CONCLUSION
Addition of TCM has better effects in participants with sepsis, while more high-quality studies are needed to draw firm conclusion.
背景
在中国，中医已被用于治疗脓毒症，但结果仍不明确。为评估中医治疗脓毒症的安全性和有效性，我们进行了这项Meta分析。
方法
检索的数据库包括发表于PubMed、Embase和Cochrane对照试验中心注册库（CENTRAL）（截至2014年12月）的随机对照试验（RCT）。纳入的研究中，对照组采用常规疗法治疗脓毒症，试验组在此基础上加用中医治疗。采用Cochrane偏倚风险标准评估方法学质量。
结果
共纳入并分析了10项RCT，涉及691名参与者。Meta分析结果显示，与单纯常规疗法相比，中医联合常规疗法可降低28天死亡率，[风险比（RR）=0.67；95%置信区间（CI）：0.510.87；P=0.002]；可缩短重症监护病房（ICU）住院时间[平均差（MD）=-1.82；95%CI：-2.60-1.04；P<0.00001]；降低急性生理与慢性健康状况评分系统（APACHE II）评分[MD=-2.95；95%CI：-3.99-1.91；P<0.00001]；治疗后血清炎症因子浓度降低[标准化均数差（SMD）=-0.50；95%CI：-0.68-0.33；P<0.00001]，亚组分析中肿瘤坏死因子-α（TNF-α）[SMD=-0.61；95%CI：-0.85-0.38；P<0.00001]和白细胞介素-6（IL-6）[SMD=-0.40；95%CI：-0.75-0.04；P=0.03]均具有统计学意义。
结论
加用中医对脓毒症患者有更好的疗效，但仍需更多高质量研究以得出确切结论。
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