奥曲肽对肝硬化食管胃底静脉曲张破裂出血维持治疗的Meta分析

目的:评价奥曲肽对肝硬化食管胃底静脉曲张破裂出血(EVB)维持治疗的疗效。方法:检索PubMed、EMBASE、Science等外文数据库(1994年1月-2011年10月)及中国期刊全文数据库、中国科技期刊数据库(维普)、万方数字化期刊全文数据库等中文数据库(1994年1月-2011年10月)中有关奥曲肽对EVB维持治疗的临床随机对照试验,采用RevMan 4.2.10软件对入选试验进行Meta分析。结果:共10项随机对照试验符合入选标准,共对810例EVB患者包括奥曲肽治疗组410例、垂体后叶素对照组400例进行分析。Meta分析结果显示:与对照组相比,奥曲肽治疗EVB的疗效显著,OR=0.29(0.20～0.42,P<0.01),表明奥曲肽总有效率高于对照组。进一步分组观察,结果提示主要的疗效来源于较高的显著疗效,OR=2.60(1.65～4.10,P<0.01)。结论:对于EVB患者,在应用传统药物进行基础治疗的同时奥曲肽可明显提高临床有效率。

Effect of octreotide on maintaining treatment of esophageal and gastric fundus varices hemorrhage:A meta-analysis

AIM: To evaluate the effect of octreotide on maintaining treatment of esophageal and gastric fundus varices hemorrhage(EVB).METHODS: PubMed,EMBase,Web of Science and The Cochrane Central Register of Controlled Trials from 1994 to 2011(up to October),and China Journal Full-text Database,Chinese Technologic Journal Database(Weipu),Wan Fang Digital Journal Full-text Database from 1994 to 2011(up to October) were retrieved in order to collect clinical randomized controlled trials regarding the effect of octreotide on maintaining treatment in EVB patients.Statistical analysis was performed by meta-analysis using Review Manager 4.2.10.RESULTS:Ten articles were included that contains total 810 patients with EVB(410 patients treated with octreotide and 400 patients treated with pituitrin).The total effective rate of octreotide group was higher than that of pituitrin group,especially of the remission rate OR=0.29(0.20-0.42,P<0.01) and the significant remission rate OR=2.60(1.65-4.10,P<0.01).CONCLUSION: Combined with conventional therapy,octreotide can improve the clinical remission rate in EVB paitents,and is superior to pituitrin.