Meta AnalysisID 4051
大黄联合早期肠内营养治疗重症急性胰腺炎的疗效：系统评价与Meta分析
CRD42019139402
Whether to conduct rhubarb combined with early enteral nutrition (rhubarb/EEN) in patients with severe acute pancreatitis (SAP) remains controversial. This study was aimed to systematically assess the efficacy and safety
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Record Fields
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- Meta Analysis Id
- 4051
- Evidence Id
- 12609
- Core Evidence Id
- 12609
- Source Meta Analysis Id
- 4010
- Herb2 Meta Analysis Id
- HBMA004010
- Crd Id
- CRD42019139402
- Title
- Efficacy of rhubarb combined with early enteral nutrition for the treatment of severe acute pancreatitis: a systematic review and meta-analysis
- Review Question
- Whether to conduct rhubarb combined with early enteral nutrition (rhubarb/EEN) in patients with severe acute pancreatitis (SAP) remains controversial. This study was aimed to systematically assess the efficacy and safety of rhubarb/EEN in SAP patients.
- Study Type Included
- Inclusion criteria: the type of design was randomized controlled trials (RCTS) Exclusion criteria: non-RCTs or quasi-RCTs and animal study;
- Condition Being Studied
- Severe acute pancreatitis (SAP) has a high mortality rate due to sepsis, necrosis, and multiple organ failure caused by pancreatic or peripancreatic infection. About 80% of deaths caused by SAP are associated with sepsis, necrosis and multiple organ failure. In the past decade, early enteral nutrition (EEN) has been introduced into SAP patients because it is beneficial for changing the lactulose/mannitol ratio, reducing the inflammatory response, maintaining the gut barrier and lowering bacterial translocation. EEN is widely used in patients with SAP, however, the efficacy of the therapeutic strategy is limited. In the last two decades, more and more clinical studies have reported the application of rhubarb combined with EEN for better effectiveness in SAP patients, especially in China. Nevertheless, the evidence from the systematic review on rhubarb for SAP is insufficient.
- Participant
- Inclusion criteria: (1) The diagnostic criteria of SAP patients refer to the criteria in the Guidelines for the Diagnosis and Treatment of Acute Pancreatitis (2014 edition); (2) Age < 80 years old; (3) Patients were diagnosed as SAP by abdominal enhanced CT examination, serum and urine amylase after admission; (4) APACHE II score > 8 points; Exclusion criteria: (1) history of cerebrovascular diseases; (2) rheumatic immune system diseases; (3) history of mental diseases; (4) severe liver and kidney diseases; (5) hematopoietic system diseases; (6) patients with malignant tumors.
- Animal
- Human Disease Modelled
- Intervention
- After admission, general routine treatment was given, including fasting, gastrointestinal decompression, acid suppression, inhibition of trypsin secretion, preventive use of antibiotics, blood volume supplementation, correction of water and electrolyte disorders, etc. Experimental group: Nasojejunal tube was used for nutritional support. The enteral nutrition infusion pump was used for 24 hours, and the total energy of nutrients was 25-35 kcal/kg.d. On the basis of routine treatment, add rhubarb treatment, select raw rhubarb powder diluted with boiling water, wait until normal temperature, put into the gastric tube.
- Comparator Control
- After admission, general routine treatment was given, including fasting, gastrointestinal decompression, acid suppression, inhibition of trypsin secretion, preventive use of antibiotics, blood volume supplementation, correction of water and electrolyte disorders, etc. Control group: Nasojejunal tube was used for nutritional support. The enteral nutrition infusion pump was used for 24 hours, and the total energy of nutrients was 25-35 kcal/kg.d.
- Main Outcome
- Inflammatory indicators: white blood cell (WBC), C-reactive protein (CRP), interleukin-6 (IL-6); Acute Physiology and Chronic Health Evaluation (APACHE II) scores; postoperative rehabilitation indicators: the length of hospital stay, the length of ICU stay, the length of severe abdominal pain, the length of abdominal distention, the length of abnormal bowel sounds, hospitalization expenditure, mortality rate, infection rate, incidence of multiple organ dysfunction syndrome (MODS). Measures of effect The indicators were measured 14 days after surgery.
- Outcome Measure
- Additional Outcome
- None Measures of effect Not applicable
- Study Method
- Meta-analysis, Systematic review
- Keyword
- Enteral Nutrition; Humans; Pancreatitis; Rheum
- Contact
- Xinrong Chen [email protected]
- Organisational Affiliation
- West China Hospital of Sichuan University
- Funding Source
- The author(s) received no financial support for the research, authorship, and/or publication of this article
- Other Selection Criteria
- Final Publication
- Same Topic Review
- Published Protocol
- Review Type
- Language
- English
- Country
- China
- Review Stage
- Review Ongoing
- First Submission Date
- 2019-06-18
- Registration Date
- 2019-08-28
- Anticipated Start Date
- 2019-03-15
- Anticipated Completion Date
- 2019-07-18
- Title Cn
- 大黄联合早期肠内营养治疗重症急性胰腺炎的疗效：系统评价与Meta分析
- Title En
- Efficacy of rhubarb combined with early enteral nutrition for the treatment of severe acute pancreatitis: a systematic review and meta-analysis
- Bilingual Status
- complete