Systematic Review of Clinical Efficacy of Xuebijing Combined with Ulinastatin in Treating Patients with Severe Sepsis

LIAO Pei-jun; LI Zhong-yong; JIN Xian-zhen

doi:10.13422/j.cnki.syfjx.2014220232

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Systematic Review of Clinical Efficacy of Xuebijing Combined with Ulinastatin in Treating Patients with Severe Sepsis

更新时间：2024-01-04

- Systematic Review of Clinical Efficacy of Xuebijing Combined with Ulinastatin in Treating Patients with Severe Sepsis
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 20, Issue 22, Pages: 232-237(2014)
- 作者机构：
- 作者简介：
- 基金信息：
- DOI：10.13422/j.cnki.syfjx.2014220232
  CLC： R459.7
- Published：2014
- 稿件说明：
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LIAO Pei-jun, LI Zhong-yong, JIN Xian-zhen. Systematic Review of Clinical Efficacy of Xuebijing Combined with Ulinastatin in Treating Patients with Severe Sepsis[J]. Chinese journal of experimental traditional medical formulae, 2014, 20(22): 232-237.
DOI：

LIAO Pei-jun, LI Zhong-yong, JIN Xian-zhen. Systematic Review of Clinical Efficacy of Xuebijing Combined with Ulinastatin in Treating Patients with Severe Sepsis[J]. Chinese journal of experimental traditional medical formulae, 2014, 20(22): 232-237. DOI： 10.13422/j.cnki.syfjx.2014220232.

摘要

目的: 系统评价血必净联用乌司他丁治疗重症脓毒症的有效性.方法:计算机检索1990—2013年在美国医学文摘数据库(Medline)、中国生物医学文献数据库(CBM)、中国期刊全文数据库(CNKI)、中文科技期刊全文数据库维普(VIP)和万方数据库

公开发表的血必净联用乌司他丁治疗重症脓毒症的随机对照研究(RCT)

提取资料后采用Rev Man 5.2统计学软件进行Meta分析.结果:共纳入8篇RCT

合计735名患者

Jada评分

2篇为3分

2篇为2分

4篇为1分.Meta分析结果显示

血必净联用乌司他丁分别与单用血必净、单用乌司他丁比较机械通气时间分别为[MD=-2.10

95%CI(-2.88

-1.31)

P<0.05]

[MD=-3.92

95%CI(-4.59

-3.25)

P<0.05];ICU住院时间分别为[MD=-2.07

95%CI(-2.98

-1.17)

P<0.05]

[MD=-3.76

95%CI(-4.57

-2.96)

P<0.05];APACHE-Ⅱ评分分别为[MD=-2.78

95%CI(-4.85

-0.71)

P<0.05]

[MD=-4.19

95%CI(-5.64

-2.75)

P<0.05];降钙素原(PCT)分别为[MD=-0.44

95%CI(-0.54

-0.33)

P<0.05]

[MD=-0.61

95%CI(-0.67

-0.55)

P<0.05];肿瘤坏死因子-α (TNF-α)分别为[MD=-1.38

95%CI(-3.02

-0.25)

P<0.05]

[MD=-5.91

95%CI(-11.02

-00.80)

P<0.05];白细胞介素-6(IL-6) 分别为[MD=-32.96

95%CI(-48.26

-17.66)

P<0.05]

[MD=-60.42

95%CI(-109.19

-11.65)

P<0.05];内毒素(LPS)分别为[MD=-6.38

95%CI(-9.18

-3.58)

P<0.05]

[MD=-11.08

95%CI(-14.42

-7.75)

P<0.05].结论:血必净联用乌司他丁能明显缩短重症脓毒症的机械通气时间、ICU住院时间和APACHE-Ⅱ评分

PCT

TNF-α

IL-6

LPS等炎性指标显著降低

但本研究纳入的研究数量偏少

且方法学上存在缺陷

证据强度不高

因此血必净联用乌司他丁治疗重症脓毒症的有效性仍需深入研究.

Abstract

Objective:To evaluate the clinical efficacy of Xuebijing combined with ulinastatin in the treatment of severe sepsis patients. Method:The medical literatures (1990 to 2013) were searched from fllowing data sources:Medline

Chinese Biomedical Literature Database

China National Knowledge Infrastructure VIP and Wanfang citation database online version

and randomized controlled trial about Xuebijing combined with ulinastatin in severe sepsis patients were collected. Meta-analysis of included trials was performed using Rev Man 5.2 software. Result:Total of 8 trials involving 735 patients was included. Of the 2 trials had a Jaded score of 3

2 trials had a Jaded score of 2

and 4 trials had a Jaded score of 1.Meta-analysis showed that the time of mechanical ventilation in Xuebijing combined with ulinastatin compare with Xuebijing and ulinastatin alone was respectively [MD=-2.10

95%CI (-2.88

-1.31)

P<0.05]

[MD=-3.92

95%CI (-4.59

-3.25)

P<0.05];the days of ICU were respectively[MD=-2.07

95%CI (-2.98

-1.17)

P<0.05]

[MD=-3.76

95%CI (-4.57

-2.96)

P<0.05];APACHE-Ⅱ was respectively [MD=-2.78

95%CI(-4.85

-0.71)

P<0.05]

[MD=-4.19

95%CI(-5.64

-2.75)

P<0.05];procalcitionin (PCT) was respectively [MD=-0.44

95%CI(-0.54

-0.33)

P<0.05]

[MD=-0.61

95%CI (-0.67

-0.55)

P<0.05];tumor necrosis factor-α (TNF-α) was respectively [MD=-1.38

95%CI(-3.02

-0.25)

P<0.05]

[MD=-5.91

95%CI(-11.02

-0.80)

P<0.05];interleukin 6(IL-6) was respectively [MD=-32.96

95%CI(-48.26

-17.66)

P<0.05]

[MD=-60.42

95%CI (-109.19

-11.65)

P<0.05];lipopolysaccharide (LPS) was respectively [MD=-6.38

95%CI (-9.18

-3.58)

P<0.05]

[MD=-11.08

95%CI (-14.42

-7.75)

P<0.05]. Conclusion:Using Xuebijing combined with ulinastatin can reduce the time of mechanical ventilation

the days of ICU and APACHE-Ⅱ

and decrease the level of proinflammatory cytokines

such as PCT

TNF-α

IL-6 and LPS. The efficacy of Xuebijing combined with ulinastatin in severe sepsis patients should be determined by more high quality RCTs because of small number and poor methodological quality of included studies in this meta-analysis.

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Related Institution

Beijing Hospital of Traditional Chinese Medicine， Capital Medical University

Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases Co-constructed by Henan Province and Education Ministry of P.R. China/Henan Key Laboratory of Chinese Medicine for Respiratory Disease，Henan University of Chinese Medicine

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The First Clinical College of Nanjing University of Chinese Medicine

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