摘要:
目的 系统评价甲磺酸加贝酯治疗急性胰腺炎的疗效和安全性。 方法 计算机检索CBM(1978年至2012年9月)、CNKI(1979年至2012年9月)、万方数据库(1999年至2012年9月)和VIP数据库(1989年至2012年9月),手工检索《中华消化杂志》(1990年至2012年9月)并进行参考文献追溯。收集比较联用甲磺酸加贝酯(加贝酯组)和不联用甲磺酸加贝酯(对照组)治疗急性胰腺炎的随机对照试验,由两位研究者根据纳入和排除标准独立进行资料提取,并依据Cochrane Handbook 5.0评价纳入文献质量后,采用RevMan 4.2软件进行Meta分析。 结果 共纳入6个随机对照试验,合计475例患者,其中加贝酯组243例,对照组232例,纳入研究均为高偏倚风险或偏倚风险不确定。Meta分析结果显示:加贝酯组治疗急性胰腺炎的有效率与对照组相比差异无统计学意义[加权均数差1.15, 95%可信区间(0.96, 1.38)],但可以更有效地缓解腹痛[加权均数差-2.08, 95%可信区间(-2.88, -1.28)]和促进血淀粉酶恢复[加权均数差-1.81, 95%可信区间(-2.73, -0.90)]。此外,其不良反应发生率较低。 结论 甲磺酸加贝酯较对照组在治疗急性胰腺炎患者时能更有效地缓解腹痛和促进血淀粉酶恢复。
Abstract:
Objective To assess the efficacy and safety of Gabexate Mesilate in treating acute pancreatitis. Methods Databases such as CBM (1978 to September 2012), CNKI (1979 to September 2012), WanFang Database (1999 to September 2012) and VIP database (1989 to September 2012) were searched on computer, and the relevant journals such as Chinese Journal of Digestion (1990 to September 2012) were also hand researched to investigate references. We collected randomized controlled trials (RCTs) about Gabexate (experimental group) compared with non-Gabexate (control group) in treating acute pancreatitis. The data were extracted according to the inclusion and exclusion criteria by two reviewers independently, the quality of the included studies was assessed according to the Cochrane Handbook for Systematic Reviews of Interventions Version 5.0, and meta-analysis was conducted by using RevMan 4.2 software. Results Among 6 RCTs involving 475 patients, 243 patients were in Gabexate group and 232 patients were in control group. The quality of the included studies was in high bias risk or uncertainty bias risk. The results of meta-analyses showed that the experimental group was more effective than the control group in easing abdominal pain (WMD= -2.08, 95%CI -2.88 to -1.28) and promoting serum amylase recovery (WMD=-1.81, 95%CI -2.73 to -0.90). There were no significant differences in effective rate (WMD=1.15, 95%CI 0.96 to 1.38). Additionally, the adverse reactions incidence in experimental group was low. Conclusion For treating patients suffering from acute pancreatitis, the Gabexate Mesilate is much more effective than the control group in easing abdominal pain and promoting serum amylase recovery.
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