目的 系统性评价垂体后叶素联合奥曲肽对肝硬化上消化道出血的疗效.方法 系统检索PubMed、The CochraneLibrary、Web of Science和万方、中国知网、中国生物医学文献数据库、维普数据库中关于垂体后叶素联合奥曲肽治疗上消化道出血临床效果的文献,检索词包括“垂体后叶素、奥曲肽、上消化道出血”,检索时限均从建库截至2016年7月.由2名研究者按照纳入与排除标准独立筛选文献、提取资料并评价质量后,采用RevMan 5.2软件进行Meta分析.结果 最终纳入7项随机对照实验,共658例患者,其中实验组337例,对照组321例.Meta分析结果显示:实验组总有效率明显高于对照组,而止血时间明显短于对照组,且差异均有统计学意义(MD=7.33,95％CI:3.83～14.03,P＜0.01;MD=-8.57,95％CI:-13.62～-3.52,P＜ 0.01).两组不良反应发生率比较,差异无统计学意义(P＞0.05).结论 与单独使用奥曲肽相比,垂体后叶素联合奥曲肽治疗上消化道出血能明显提高总有效率,缩短止血时间.%Objective To systemically review the efficacy of hypophysin combined with Octreotide in the treatment of liver cirrhosis with upper gastrointestinal hemorrhage.Methods The literatures about the efficacy of hypophysin combined with Octreotide in the treatment of upper gastrointestinal hemorrhage were searched systemically in the database of PubMed,The Cochrane Library,Web of Science and WanFang,CNKI,CBM and VIP,the search words included "hypophysin,Octreotide,upper gastrointestinal hemorrhage",the retrieval time limit was from the establishment of database to July 2016,2 reviewers independently screened literatures according.to the inclusion and exclusion criteria,extracted data,and assessed the risk of bias of included studies.Then Meta-analysis was performed using RevMan5.2 software.Results A total of 7 RCTs involving 658 patients were included,including 337 cases in the experimental group and 321 cases in the control group.The results of Meta-analysis showed that the total effective rate of experimental group was higher than that of the control group,the hemostatic time was shorter than that of control group,the differences were all statistically significant (MD =7.33,95％CI:3.83-14.03,P ＜ 0.01;MD =-8.57,95％CI:-13.62--3.52,P ＜ 0.01).There was no significant difference in the incidence of adverse reactions between the two groups (P ＞0.05).Conclusion Compared to the single use of Octreotide,hypophysin combined with Octreotide can effectively improve the total effective rate and shorten the hemostatic time.
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