Meta-analysis of Therapeutic Efficacy of Purgation and Catharsis Method for Treating Severe Pneumonia

摘要

[Objectives]To make a systematic evaluation on the therapeutic efficacy of purgation and catharsis method combined with western medicine in treatment of severe pneumonia.[Methods]The literatures were retrieved from China Knowledge Infrastructure(CNKI),Chinese science and technology journal full-text database(VIP database,VIP),Wanfang Data,the Chinese biomedical database,PubMed,Embase,and the Cochrane Library.The retrieval time was set to the period from the creation of the database to June 2020.The randomized controlled trial(RCT)was conducted on the comparison between the purgation and catharsis method combined with western medicine and the western medicine alone in the treatment of severe pneumonia.The literature information was extracted and the methodological quality of the included literature was evaluated according to the bias risk assessment tool developed by the Cochrane Collaboration.Meta-analysis was performed with the aid of RevMan 5.3 software for the patient response rate,acute physiology and chronic health evaluations II(APACHE II),clinical pulmonary infection score(CPIS),oxygenation index(OI),procalcitonin(PCT),mechanical ventilation time,etc.[Results]A total of 20 articles were included,involving a total of 1661 patients,and the literature quality was low.Meta analysis results showed that compared with the treatment by western medicine alone,the purgation and catharsis method combined with western medicine can further improve the response rate[RR=1.21,95%CI(1.14,1.27),P<0.00001],and reduce the APACHE II score[WMD=-5.92,95%CI(-7.94,-3.89),P<0.00001],reduce CPIS score[WMD=-1.41,95%CI(-1.70,-1.12),P<0.00001],increase oxygenation index[WMD=39.52,95%CI(29.39,49.65),P<0.00001],reduce PCT level[WMD=-2.85,95%CI(-3.68,-2.01),P<0.00001],shorten the mechanical ventilation time[WMD=-13.00,95%CI(-16.51,-9.48),P<0.00001].[Conclusions]Within the scope of the study included,the purgation and catharsis method combined with western medicine in the treatment of severe pneumonia can further reduce the pulmonary infection,reduce PCT levels,increase oxygenation index,and improve vital organ functions,thereby improving clinical efficacy,shortening the mechanical ventilation time(MVT),and reducing the economic burden of patients.