The Effect Of Using Thiamine,Ascorbic Acid And Glucocorticoid Triple Therapy In The Treatment Of Sepsis: A Meta-Analysis

Objective:Regarding the role of thiamine,ascorbic acid,and glucocorticoid triple therapy in the treatment of sepsis,a lot of experiments have been conducted,but the results are conflicting.We conducted a Meta analysis to explore the effect of thiamine,ascorbic acid and glucocorticoid triple therapy in the treatment of sepsis.Methods:We searched Pubmed,Cochrane Library,Embase,CNKI,Wanfang,Weipu and other databases by computer,including randomized controlled trials and cohorts to evaluate the efficacy of thiamine,ascorbic acid and glucocorticoids in sepsis.The research period is from the establishment of the database to February 2021.Then,two researchers independently carried out literature screening,quality evaluation,extracted the basic characteristics of literature and related data according to the inclusion and exclusion criteria,and used STATA 12.0 software for Meta analysis and evaluation.Results:Finally,13 studies were included,including 6 cohort studies and 7 randomized controlled trials,with 1,423 patients participating in the study.Meta-analysis results showed that intravenous injection of thiamine,ascorbic acid and glucocorticoids had no significant effect on reducing mortality in patients with sepsis(OR=0.844,95%confidence interval:0.664～1.071,p=0.163,I~2=35.4%).It has no significant effect on the mortality of patients with sepsis in the intensive care unit(OR=0.851,95%confidence interval:0.666～1.087,p=0.197,I~2=44.7%),and it can’t shorten the length of stay in the intensive care unit(SMD=0.005,95%confidence interval:-0.188～0.199,p=0.956,I~2=50.5%),and duration of hospitalization(SMD=0.119,95%confidence interval:-0.000～0.238,p=0.005,I~2=0%).The 72-hour SOFA score change could not be improved(SMD=0.247,95%confidence interval:-0.108～0.602,p=0.173,I~2=87.6%).Conclusion:This study shows that compared with the control group,the combined application of intravenous thiamine,ascorbic acid and glucocorticoids can’t significantly reduce the in-patient mortality and intensive care unit mortality of patients with sepsis,shorten the length of hospital stay and the length of stay in the intensive care unit,improve the change of 72-hour SOFA score.