A Meta - Analysis Of Rhubarb In Prevention And Treatment Of Severe Gastrointestinal Dysfunction / Failure

Purpose: Evaluating the clinical efficacy of rhubarb preventing critically ill patients with gastrointestinal failure, providing evidence of evidence-based medicine for the application of rhubarb prevent and cure critically ill patients with gastrointestinal failure.Material and method:Establishing inclusion criteria,retrieval paper, which published in domestic journals about randomized controlled trials of rhubarb treat critically ill patient, between January 1989 and December 2015.Using the Jadad score to rate the quality of the papers, using Rev Man 5.3 in meta-analysis.Results:There are 11 into researches, of which 5 high quality researches, 6 low quality researches. Meta-analysis results:1.The incidence of gastrointestinal mucosa lesions with bleeding in rhubarb treatment group patients is lower then control group, the difference has statistical significance[RR=0.42,95%CI(0.35,0.52),Z=8.63,P<0.00001].2.The incidence of enteroplegia in rhubarb treatment group patients is lower then control group, the difference has statistical significance[RR=0.38,95%CI(0.30,0.48),Z=8.24,P<0.00001].3.The incidence of MODS in rhubarb treatment group patients is lower then control group, the difference has statistical significance[RR=0.45,95%CI(0.38,0.53),Z=9.04,P<0.00001].4.The case fatality rate of MODS in rhubarb treatment group patients is lower then control group, the difference has statistical significance[RR=0.24,95%CI(0.14,0.44),Z=4.75,P<0.00001].5. 210 patients with gastrointestinal mucosa lesions with bleeding using rhubarb treatment, Among them, 160 patients with effective treatment, 76.2% efficient; 170 patients with intestinal paralysis rhubarb treatment, of which 137 patients with effective treatment, 80.6% efficient.6.Critically ill patients who treat by rhubarb both before and after gastrointestinal failure occur can reduce the duration of gastrointestinal function failure, the difference has statistical significance[MD=-3.30,95%CI(-3.81,-2.78),Z=12.56,P<0.00001].Conclusion:Rhubarb reduce the incidence of gastrointestinal mucosa lesions with bleeding and enteroplegia, reduce MODS and death risk of MODS effectively for critically ill patient. When gastrointestinal mucosa lesions with bleeding and enteroplegia occur, treat by rhubarb can obtain good curative effect. Early applicating rhubarb to treat critically ill patients, can reduce the duration of gastrointestinal function failure.