目的 系統(tǒng)評價異甘草酸鎂靜輔助治療重癥急性胰腺炎（SAP）的有效性和安全性。方法 計算機檢索中國學術期刊全文數據庫（CNKI）、維普中文期刊全文數據庫（VIP）、中國生物醫(yī)學文獻數據庫（CBM）、萬方數據庫、PubMed、EmBase和The Cochrane Library數據庫有關常規(guī)治療聯合異甘草酸鎂（試驗組）對比常規(guī)治療（對照組）治療SAP的隨機對照試驗（RCTs），檢索時間為從建庫到2020年10月。提取數據、評價文獻質量后，采用RevMan 5.3軟件進行Meta分析。結果 最終納入12篇RCTs和1 161例受試者。Meta分析結果顯示：試驗組臨床有效率[RR=1.23，95% CI=（1.17，1.30），P<0.01]顯著大于對照組；試驗組CRP水平下降值[SMD=-1.67，95% CI=（-2.41，-0.93），P<0.01]、TNF-α水平下降值[SMD=-1.17，95% CI=（-1.55，-0.78），P<0.01]和IL-6水平下降值[SMD=-1.40，95% CI=（-1.86，-0.94），P<0.01]均顯著大于對照組；試驗組治療后ALT水平[SMD=-2.35，95% CI=（-2.90，-1.79），P<0.01]和AST水平[SMD=-1.77，95% CI=（-2.46，-1.08），P<0.01]均顯著小于對照組。ADR發(fā)生率組間比較無顯著性差異[RR=1.49，95% CI=（0.88，2.54），P=0.14]。結論 異甘草酸鎂能顯著降低SAP患者炎性因子，改善肝腎功能，減少臨床體征改善時間，改善早期預后，且安全性好。

Objective To evaluate the efficacy and safety of magnesium isoglycyrrhizinate in the adjuvant treatment of the patients with severe acute pancreatitis (SAP). Methods Randomized controlled trials (RCTs) about the routine treatment combined with magnesium isoglycyrrhizinate (test group) compared with the routine treatment (control group) in the treatment of SAP was searched in CNKI, Wanfang, VIP, CBM, PubMed EmBase and the Cochrane Library databases from inception to October 2020 by computer. Meta-analysis was performed on the homogeneous study using RevMan 5.3 software after screened the literature, evaluated the quality of included studies. Results A total of 12 RCTs and 1 161 patients were included. The Metaanalysis showed that the test group of the clinical effective rate[RR=1.23, 95%CI=(1.17, 1.30), P < 0.01] was significantly higher than that in the control group; the test group of the decrease values of CRP levels[SMD=1.67, 95%CI=(2.41, 0.93), P < 0.01], TNFα levels[SMD=-1.17, 95%CI=(-1.55, -0.78), P < 0.01] and IL-6 levels[SMD=-1.40, 95%CI=(-1.86, -0.94), P < 0.01] were all significantly higher than those in the control group; after the treatment, the test group of ALT levels[SMD=-2.35, 95%CI=(-2.90, -1.79), P < 0.01] and AST levels[SMD=-1.77, 95%CI=(-2.46, -1.08), P < 0.01] were all significantly lower than those in the control group. There was no significant difference in rate of ADR[RR=1.49, 95%CI=(0.88, 2.54), P =0.14]. Conclusion Magnesium isoglycyrrhizinate can significantly reduce inflammatory factors, improve liver and kidney function, reduce clinical signs to improve the time, improve early prognosis, meanwhile with good safety.

R286.5

衡水市科技計劃項目（2019014059Z）