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目的:用循证医学的方法评价中药联合西医常规治疗急性胰腺炎的疗效。方法:检索建库至今中国生物医学文献数据库、CNKI数据库、维普数据库、万方数据库发表的有关中药口服联合西医常规治疗急性胰腺炎疗效的随机对照临床试验相关文献。根据纳入及排除标准,有15项临床试验,1267例AP患者(中药口服治疗组665例,对照组602例)纳入本研究。使用Rev Man 5.2软件合并分析纳入研究的急性胰腺炎患者的有效率、血淀粉酶恢复正常时间、腹痛缓解时间、腹痛持续时间及平均住院天数等结局指标。结果:中药口服联合治疗组的有效率合并效应量RR值为4.35,95%CI为(2.97,6.37),Z=7.56,P<0.000 01;χ2=5.70,df=14,P=0.97>0.05,I2=0%,表明15项的研究资料具有同质性,故采用固定效应模型分析。血淀粉酶恢复正常时间WMD=-2.11,95%CI为(-2.45,-1.76),P<0.000 01;腹痛缓解时间WMD=-1.72,95%CI为(-2.18,-1.25),Z=7.26,P<0.000 01;患者平均住院天数WMD=-4.53,95%CI为(-5.82,-3.24),Z=6.88,P<0.000 01,均明显低于对照组,差异有统计学意义。结论:中药口服联合西医常规治疗能显著缩短急性胰腺炎患者腹痛缓解时间,缩短血淀粉酶恢复正常时间,减少患者平均住院天数,明显提高治疗的有效率。
Objective: To evaluate the curative effect of traditional Chinese medicine and western medicine on acute pancreatitis by means of evidence-based medicine. METHODS: The related literatures about randomized controlled clinical trials on the efficacy of traditional Chinese medicine combined with traditional western medicine in the treatment of acute pancreatitis were searched in Chinese Biomedical Literature Database, CNKI Database, VIP Database and Wanfang Database. According to inclusion and exclusion criteria, 15 clinical trials, 1267 patients with AP (665 oral traditional Chinese medicine treatment group, control group of 602 patients) were included in this study. The Rev Man 5.2 software was used to analyze the outcomes of patients enrolled in the study, including the efficacy of amylase, the duration of blood amylase recovery, the duration of abdominal pain relief, the duration of abdominal pain and the average length of stay. Results: The effective combined effect (RR) was 4.35, 95% CI (2.97, 6.37), Z = 7.56, P <0.000 01, χ2 = 5.70, df = 14, P = 0.97> 0.05 , I2 = 0%, indicating that 15 items of research data with homogeneity, so the fixed effect model analysis. Blood amylase recovery time WMD = -2.11,95% CI was (-2.45, -1.76), P <0.000 01; the pain relief time WMD = -1.72, 95% CI was (-2.18, -1.25), Z = 7.26, P <0.000 01; mean length of stay in patients with WMD = -4.53, 95% CI of (-5.82, -3.24), Z = 6.88, P <0.000 01, were significantly lower than the control group, the difference was statistically significant. Conclusion: Oral administration of traditional Chinese medicine combined with Western routine therapy can significantly reduce the pain relief time of patients with acute pancreatitis, shorten the recovery time of serum amylase, reduce the average length of stay in patients, significantly improve the efficiency of treatment.