Department of Pharmacy, Cadre Sanatorium of Hainan & Geriatric Hospital of Hainan (CSH), Haikou, China.
Department of Second District of Critical Medicine, The Second Affiliated Hospital of Hainan Medical University, Haikou, China.
Ann Palliat Med. 2021 Dec;10(12):12456-12466. doi: 10.21037/apm-21-3179.
Sepsis is a systemic infectious inflammatory response syndrome, which can release a large number of inflammatory mediators in serum, resulting in organ dysfunction. This study conducted a systematic review and meta-analysis of the reports of traditional Chinese medicine (TCM) in the treatment of sepsis in recent years, providing evidence for clinical diagnosis and treatment.
The databases of PubMed, Chinese Medical Literature (CBM), China National Knowledge Infrastructure (CNKI), Medline, and Web of Science were searched for clinical randomized controlled trials (RCTs) related to "Chinese traditional medicine" and "Sepsis" published from January 2015 to August 2021. After screening qualified articles, RevMan 5.4 software was used to evaluate the bias of included studies and perform meta-analysis.
Finally, 8 articles were retrieved and screened, and a total of 862 patients entered the study. The results of meta-analysis showed that serum interleukin-6 (IL-6) levels were lower in sepsis patients after TCM treatment [mean difference (MD) =-20.70; 95% confidence interval (CI): -33.68 to -7.73; P=0.002]; tumor necrosis factor-α (TNF-α) levels were lower (MD =-4.17; 95% CI: -5.98 to -2.37; P<0.00001); acute physiological assessment and chronic health evaluation (APACHE) II scores were lower (MD =-2.92; 95% CI: -3.50 to -2.35; P<0.00001); mortality was lower [odds ratio (OR) =0.49; 95% CI: 0.33 to 0.74; P=0.0006]; and effective rate was higher (OR =3.43; 95% CI: 1.72 to 6.85; P=0.0005).
On the basis of traditional western medicine treatment of sepsis, the addition of TCM treatment can effectively reduce the serum inflammatory response, improve the patient's immunity, and improve treatment efficacy.
脓毒症是一种全身性感染性炎症反应综合征，可在血清中释放大量炎症介质，导致器官功能障碍。本研究对近年来中医药治疗脓毒症的报道进行了系统评价和荟萃分析，为临床诊断和治疗提供了证据。
检索 PubMed、中国生物医学文献数据库（CBM）、中国知网（CNKI）、Medline 和 Web of Science 数据库，收集 2015 年 1 月至 2021 年 8 月发表的关于“中药”和“脓毒症”的临床随机对照试验（RCT）。筛选合格文献后，采用 RevMan 5.4 软件评价纳入研究的偏倚，并进行荟萃分析。
最终检索到 8 篇文献并进行筛选，共 862 例患者纳入研究。荟萃分析结果显示，中医药治疗后脓毒症患者血清白细胞介素-6（IL-6）水平降低[均数差（MD）=-20.70；95%置信区间（CI）：-33.68 至-7.73；P=0.002]；肿瘤坏死因子-α（TNF-α）水平降低（MD=-4.17；95% CI：-5.98 至-2.37；P<0.00001）；急性生理学和慢性健康评估（APACHE）Ⅱ评分降低（MD=-2.92；95% CI：-3.50 至-2.35；P<0.00001）；死亡率降低[比值比（OR）=0.49；95% CI：0.33 至 0.74；P=0.0006]；有效率升高（OR=3.43；95% CI：1.72 至 6.85；P=0.0005）。
在西医治疗脓毒症的基础上，加用中医药治疗可有效降低血清炎症反应，提高患者免疫力，改善治疗效果。
