血必净降低脓毒性休克患者病死率的系统评价

发布时间：2018-04-04 21:43

本文选题：血必净　切入点：脓毒性休克　出处：《中华中医药学刊》2016年09期

【摘要】：目的:系统评价血必净注射液(XBJ)对脓毒性休克(SS)患者不同时点病死率的效应。方法:全面检索相关随机对照试验(RCT),按照预定标准筛选文献、总结并提炼信息,使用Jadad量表进行质量评估,并采用Rev Man 5.3对结果进行统计分析。结果:最终仅8个RCT被纳入,相对于常规治疗组而言,常规治疗基础上加用XBJ能够使SS患者7 d病死率降低约39%~46%,14 d病死率降低约2%~47%,28d病死率降低约39%~49%。结论:尽管纳入的研究质量较低和方法学较弱会使结论应用具有一定局限,但由于本研究结合了符合方案集(PP)分析和意向性(ITT)分析两种分析方法,会使最终结果相对准确一些,考虑到被纳入的各个研究间具有较好的同质性及加用血必净可能会使SS患者病死率大幅度下降,足够证据表明血必净可以作为脓毒症的补充治疗措施之一,但此结论尚需今后更严谨的试验设计,更长随访周期,更大样本量,多中心的RCT来进一步验证。
[Abstract]:Objective: to evaluate the effect of XBJ injection on mortality at different time points in patients with septic shock.Methods: the relevant randomized controlled trials were searched, the literature was screened according to the predetermined criteria, the information was summarized and extracted, the quality was evaluated with Jadad scale, and the results were statistically analyzed by Rev Man 5.3.Results: at last, only 8 RCT were included. Compared with the routine treatment group, adding XBJ to the routine treatment group could reduce the mortality rate of SS patients on 7 days by about 390.4646 / 14d. The fatality rate of patients with SS was reduced by about 2.474728d and the fatality rate of patients with SS was reduced by 3949.Conclusion: although the low quality of the included studies and the weak methodology may limit the application of the conclusions, the final results will be relatively accurate due to the combination of PP- and ITT- analysis.Considering that better homogeneity among the various studies included and the possibility that the combination of Xue Bijing could significantly reduce the mortality of patients with SS, there is sufficient evidence that Xuebijing can be used as a complementary treatment for sepsis,However, this conclusion needs to be further verified by more rigorous experimental design, longer follow-up period, larger sample size and multi-center RCT in the future.
【作者单位】：广州中医药大学第二临床医学院;广东省中医院;
【基金】：国家中医药管理局中医治未病项目标准修订项目(SATCM-2014-BZ〔182〕) 广东省科技厅项目(2015A020210093)
【分类号】：R459.7

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