The Clinical Curative Effect Of Rhubarb Joint Mirabilite On Severe Acute Pancreatits:a Meta-Analysis

Objectives To evaluate the effectiveness of rhubarb joint mirabilite in the treatment of severe acute pancreatitis according to a Meta-Analysis,providingthe evidence of evidence-based medicine for Traditional Chinese medicine in the treatment of SAP,so as to provide some reference value for clinical workers.Methods Relevant randomized controlled clinical trials(RCTs)were collected by retrieving the relevant articles published on CNKI,VIP,WanFang,PubMed,OVID,Elsevier Science Direct electronic databases from March of 2004 to April of 2014.Two reviewers independently screened studies according tothe included and exclusion criteria,extracting data and assessed quality of the included studies.Then meta-analysis was performed by using RevMan 5.2 software.Results Thirteen RCTs were identified finally from four hundred and fifty-six studies through the strict screening,involving seven hundred and ninety-six patients,concluding three hundred and ninety patients of control group(conventional western medicine treatment group)and four hundred and six patients of treatment group(rhubarb joint mirabilite with conventional western medicine treatment group).The studies in the first defecation time(nine studies),abdominal pain relief time(twelvestudies),abdominal distension relief time(eight studies)are heterogeneous,conductingMeta analysis by using the random effect model,the combined results have significant statistical differences,the first defecation time(MD=-1.73,95%CI-2.15 to-1.31,P<0.00001),abdominal pain relief time(MD=-1.86,95%CI-2.51 to-1.21,P<0.00001),abdominal distension relief time(MD=-2.22,95%CI-2.81 to-1.63,P<0.00001),average hospitalization days(MD=-6.18,95%CI-7.86 to-4.50,P<0.00001),namely the treatment group wasbetter than control group;the incidence of complications(five studies),hospital death(seven studies)are homogeneous,conducting Meta analysis by using fixed effect model,the combinedresults have significant statistical differences,the incidence of complications(RR=0.42,95%CI 0.27 to 0.65,P<0.0001),hospital death(RR=0.44,95%CI 0.24 to 0.83,P=0.01),namely the treatment group wasbetter than control group.Conclusion The adjunctive therapy with rhubarb and mirabilite on severe acute pancreatitis can significantly shorten the first defecation time,abdominal distension relieve time,abdominal pain relief time,average hospitalization days,and can significantly reduce the incidence of complications and hospital death.Due to the limited quality and quantity of the included studies,more high quality studies with larger sample size are needed to verify the above conclusion.