大承气汤加减治疗术后早期炎性肠梗阻的Meta分析
Meta-analysis of the Dachengqi decoction in the treatment of the early postoperative inflammatory intestinal obstruction
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摘要: 目的：评价大承气汤加减联合西医治疗术后早期炎性肠梗阻的临床疗效。方法：在中国期刊全文数据库、中国生物医学文献数据库、万方等数据库检索相关文献，利用RevMan5.2软件对数据进行统计分析。结果：共纳入21项研究，1 307例患者。Meta分析结果显示：大承气汤加减联合西医治疗术后早期炎性肠梗阻的治愈率高于单纯西医治疗[OR=5.16，95%CI（3.30~8.06），P<0.01]。大承气汤加减联合西医治疗组的肛门恢复排气时间短于单纯西医治疗组[WMD=-1.50，95%CI（-1.95~-1.15），P<0.01]，住院时间短于单纯西医治疗组[WMD=-3.45，95%CI（-4.55~-2.35），P<0.01]，血清白细胞介素-6水平低于单纯西医治疗组[SMD=-6.01，95%CI（-9.19~2.84），P<0.01]；2组血清肿瘤坏死因子-α水平差异无统计学意义[SMD=-1.87，95%CI（-4.00~0.27），P>0.05]。结论：大承气汤加减联合西医治疗能有效提高术后早期炎性肠梗阻的治愈率，缩短肛门恢复排气时间和住院时间，降低患者血清白细胞介素-6水平。Abstract: Objective: To evaluate the clinical effects of Dachengqi decoction combined with Western medicine in the treatment of early postoperative inflammatory intestinal obstruction.Methods: The related literatures were searched from CNKI,CBM and Wanfang database,and statistically analyzed using RevMan5.2 software.Results: Twenty-one studies and 1 037 patients were selected.The results of Meta-analysis showed that the cure rate of the Dachengqi decoction combined with Western medicine in the treatment of early postoperative inflammatory intestinal obstruction was higher than that of Western medicine[OR=5.16,95%CI(3.30 to 8.06),P<0.01].The recovery time of anus exhaust in the patients treated with the Dachengqi decoction combined with Western medicine was shorter than that in the patients treated with Western medicine[WMD=-1.50,95%CI(-1.95 to -1.15),P<0.01].The hospitalization time in the patients treated with the Dachengqi decoction combined with Western medicine was shorter than that in the patients treated with Western medicine[WMD=-3.45,95%CI(-4.55 to -2.35),P<0.01].The serum level of interleukin-6 in the patients treated with the Dachengqi decoction combined with Western medicine was lower than that in the patients treated with Western medicine[SMD=-6.01,95%CI(-9.19 to 2.84),P<0.01].The difference of the serum level of tumor necrosis factor-α between two groups was not statistically significant[SMD=-1.87,95%CI(-4.00 to 0.27),P>0.05].Conclusions: The treatment of early postoperative inflammatory intestinal obstruction with Dachengqi decoction combined with Western medicine can effectively improve the cure rate,shorten the recovery time of of anus exhaust and hospitalization time,and decrease the serum level of interleukin-6 of patients.
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