造影劑腎病中西醫(yī)結合預防的meta分析
[Abstract]:Objective: to evaluate the clinical efficacy and safety of integrated traditional Chinese and western medicine in the prevention of contrast agent nephropathy, and to provide evidence-based evidence for clinical prevention of contrast agent nephropathy. Materials and methods: according to the steps of Cochrane system evaluation (I. E. 1. Ask questions. Identify and select the original research report. The original research report was evaluated. Collect data. Analysis and report on the results of the study. Explain the result. Improve and update the original evaluation) strict formulation of detailed inclusion criteria and exclusion criteria. Computer Retrieval of full text Database of Chinese Journals, full text Database of Chinese Sci-tech Journals, Wanfang Database, Chongqing Weipu Database, Chinese Biomedical Literature Database, Chinese scientific citation database collected from 2008-2017 integrated Chinese and western medicine (treatment group) compared with other methods (control group) for the prevention of contrast agent nephropathy (CIN) randomized controlled trial (RCT), two researchers independently evaluated the retrieval of the articles used Inclusion and exclusion criteria, The quality of literature was evaluated, and the data were extracted and cross-checked. Meta analysis was carried out with Rev Man 5.3 software. Outcome measure: incidence of (Scr), and incidence of serum creatinine. Results: a total of 2738 cases were included in 23 items of RCT, 1375 cases in the treatment group and 1363 cases in the control group. Compared with the control group, (1) 23 articles compared the incidence of contrast agent nephropathy between the combination of traditional Chinese and western medicine and the control group: there was no statistical heterogeneity among the studies (P0. 00%). The fixed effect model was used to analyze. Meta-analysis results showed that there was no statistical heterogeneity between the two groups. , [RR=0.25,95%CI (0.19 ~ 0.34) P 0.00001], the difference of effective rate between the two groups was statistically significant. It was suggested that the incidence of contrast agent nephropathy was significantly higher than that of the control group. (2) 23 studies reported using the mean serum creatinine value 1-7 days after angiography, and selecting the highest mean serum creatinine value for meta analysis. There was statistical heterogeneity (P0.00001). The results of random effect model analysis. Meta-analysis showed that [MD=-11.24,95%CI (-12.76-9.72)] P0.00001, the difference was statistically significant. It was suggested that the mean serum creatinine level in the treatment group was significantly lower than that in the control group after the treatment of integrated Chinese and western medicine. (3) the adverse reactions of the control group and the treatment group were explained in 15 studies. There was no statistical heterogeneity (P < 1.00). The results of fixed effect model analysis. Meta-analysis showed that [OR=0.22,95%CI (0.100.49) / P 0.0002], the difference was statistically significant, suggesting that integrated Chinese and western medicine can prevent contrast agent nephropathy, and the incidence of adverse reactions in clinical is less than that in western medicine group. Conclusion: the combination of traditional Chinese and western medicine can prevent the occurrence of contrast agent nephropathy, and decrease the serum creatinine level after contrast, and the incidence of adverse reactions is obviously lower than that in the control group. This study is limited in literature and needs to be confirmed by more quality and higher-quality randomized controlled trials in clinical practice.
【學位授予單位】:遼寧中醫(yī)藥大學
【學位級別】:碩士
【學位授予年份】:2017
【分類號】:R692
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