A Meta-analysis Of Traditional Chinese Medicine In The Treatment Of Gastrointestinal Dysfunction In Sepsis

Objective:by using the method of Meta analysis of traditional Chinese medicine in the treatment of sepsis randomized controlled trial of gastrointestinal dysfunction analysis,the end of the indexes and quality evaluation,in order to objectively evaluate the Chinese medicine treatment of sepsis clinical curative effect of gastrointestinal dysfunction,provide theoretical basis for the treatment of traditional Chinese medicine and for the future reference.Methods:from China national knowledge network(CNKI),WANFANG DATE(WANFANG DATE),viper Chinese journal of science and technology(VIP)full-text database from December 2019 to retrieve Chinese medicine treatment of sepsis gastric gastrointestinal dysfunction related articles.The retrieved documents were loaded into the software(NoteExpress)for rechecking,and the documents were screened according to inclusion criteria and exclusion criteria.Cochrane risk assessment tool was used for bias analysis,and Review Manger5.3 software was used for Meta analysis of outcome indicators,and forest maps and funnel plots were drawn.Results:a total of 28 clinical randomized controlled trials were included,with 2066 subjects.There were few high risk factors in the included literature,and there were more blind uncertainty risks in the randomization of concealment,double-blind and outcome measurement.No significant publication bias was found.Results of Meta analysis:clinical efficacy in the TCM treatment group RR(95%CI)=(1.23-1.46),Z=6.59,P<0.00001.TCM syndrome integral[MD(95%CI)=4.41(5.19,3.62),Z=11.01,P<0.00001];[SMD(95%CI)=-1.21(-1.49,-0.92),Z=8.34,P<0.00001].-APACHE ?[MD(95%CI)=-3.25,(-3.68,-2.83),Z=15.04,P<0.00001];SOFA[MD(95%CI)=-0.90(-1.13,-0.67),Z=7.56,P<0.00001];Peripheral blood leukocytes[MD(95%CI)=-2.68(-3.07,-2.29),Z=13.5,P<0.00001];Serum CRP level[MD(95%CI)=-14.77(-20.11,-9.43),Z=5.42,P<0.00001];PCT levels[SMD(95%CI)=1.57(2.05,1.09);the Z=6.39,P<0.00001];DAO[SMD(95%CI)=1.99(2.78,1.20),Z=4.94,P<0.00001];D-lactic acid[SMD(95%CI)=1.27(1.91,0.62),Z=3.87(P=0.0001)];ET[SMD(95%CI)=1.27(1.91,0.62),Z=3.86,P=0.0001).TNF alpha[SMD(95%CI)=0.94(1.19,0.69),Z=7.35,P<0.00001];IL-6[SMD(95%CI)=0.90(1.29,0.50),Z=4.45,(P<0.00001)];ICU length of hospital stay[MD(95%CI)=4.63(5.30,3.97),Z=13.66,P<0.00001];The incidence of MODS[RR(95%CI)=0.50(0.32,0.78),Z=3.02,P=0.003];Case fatality[RR(95%CI)=0.38(0.26,0.55),Z=5.21,P<0.00001].Conclusion:traditional Chinese medicine to improve clinical curative effect of gastrointestinal dysfunction efficiently,reduce the TCM syndrome integral,APACHE ? score,SOFA score,improve the white blood cell count,calcitonin,c-reactive protein and serum diamine oxidase,D?lactic acid and endotoxin,tumor necrosis factor alpha and interleukin-6,length of hospital stay,reduce the ICU MODS incidence and case fatality rate than conventional western medicine treatment effect is good.