Zhou Yejiang, Wang Lulu, Huang Xinwu, Li Hua, Xiong Yuxia
Department of Gastrointestinal Surgery, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China.
Department of Pharmacology, School of Medicine, Southwest Medical University, Luzhou 646000, Sichuan, China.
J Ethnopharmacol. 2016 Dec 24;194:495-505. doi: 10.1016/j.jep.2016.09.053. Epub 2016 Sep 29.
Rhubarb is one of the common herbs used in traditional Chinese complex prescriptions for the treatment of various inflammatory diseases. We sought to determine the add-on effect of crude rhubarb to somatostatin in patients with acute pancreatitis by conducting a meta-analysis.
We searched the Pubmed, EMBASE, Cochrane Library, CNKI, Wanfang, VIP databases up to November 2015. Randomized controlled trials (RCTs) comparing crude rhubarb plus somatostatin to somatostatin alone for acute pancreatitis were included. Risk ratio (RR) or weighted mean difference (WMD) with their 95% confidence interval (CI) was calculated between with and without crude rhubarb therapy.
A total of 19 RCTs involving 1161 patients were identified. Compared with somatostatin alone, crude rhubarb plus somatostatin significantly reduced the total complications (RR 0.55; 95% CI 0.41-0.73) and APACHE Ⅱ scores (WMD -1.16; 95% CI -1.91 to -0.41) as well as shortened the duration of elevated serum amylase (WMD -2.01 days; 95% CI -2.57 to -1.44), duration of abdominal pain (WMD -1.33 days; 95% CI -1.61 to -1.05), the first defecation time (WMD -2.27 days; 95% CI -3.06 to -1.47), and duration of hospital stay (WMD -6.70 days; 95% CI -8.81 to -4.60). However, there were no significant differences in total mortality rates (RR 0.61; 95% CI 0.34 to 1.12) between two groups.
Crude rhubarb as adjuvant therapy to somatostatin appears to have additional benefits in patients with acute pancreatitis. However, interpretation of these results should be cautioned due to the methodological flaws.
大黄是用于治疗各种炎症性疾病的传统中药复方中常用的草药之一。我们试图通过进行一项荟萃分析来确定生大黄对急性胰腺炎患者生长抑素的附加作用。
我们检索了截至2015年11月的Pubmed、EMBASE、Cochrane图书馆、CNKI、万方、维普数据库。纳入了比较生大黄加生长抑素与单独使用生长抑素治疗急性胰腺炎的随机对照试验（RCT）。计算了使用和不使用生大黄治疗之间的风险比（RR）或加权平均差（WMD）及其95%置信区间（CI）。
共确定了19项涉及1161例患者的RCT。与生大黄加生长抑素相比，单独使用生长抑素显著降低了总并发症（RR 0.55；95% CI 0.41 - 0.73）和急性生理与慢性健康状况评分系统Ⅱ（APACHEⅡ）评分（WMD -1.16；95% CI -1.91至 -0.41），并缩短了血清淀粉酶升高持续时间（WMD -2.01天；95% CI -2.57至 -1.44）、腹痛持续时间（WMD -1.33天；95% CI -1.61至 -1.05）、首次排便时间（WMD -2.27天；95% CI -3.06至 -1.47）以及住院时间（WMD -6.70天；95% CI -8.81至 -4.60）。然而，两组之间的总死亡率没有显著差异（RR 0.61；95% CI 0.34至1.12）。
生大黄作为生长抑素的辅助治疗似乎对急性胰腺炎患者有额外益处。然而，由于方法学上的缺陷，对这些结果的解释应谨慎。
