본문 바로가기
KERD
논문KCI 등재

고지혈성 급성 췌장염에 대한 대시호탕의 효과 : 체계적 문헌고찰과 메타분석

The Effect of Dachaihu Decoction for Hyperlipidemic Acute Pancreatitis: A Systematic Review and Meta-Analysis

정유진|박동일|김윤정
대한한방내과학회 (The Society Of Korean Oriental Internal Medicine)|2020.06|대한한방내과학회지 (The Journal of Korean Oriental Internal Medicine)|제41권 제3호|pp. 306-325|DOI https://doi.org/10.22246/jikm.2020.41.3.306

1

조회

0

다운로드

1

인용

0

참고문헌

키워드

meta-analysissystematic reviewCNKIhyperlipidemic acute pancreatitisDachihu decoction
주제분류한의학

초록

Objectives: The aim of this study is to investigate the effect of a Dachaihu decoction for hyperlipidemic acute pancreatitis (HLAP) by systematic review and meta-analysis of Chinese clinical studies. Methods: China National Knowledge Infrastructure (CNKI) was utilized as the major search engine. The date of the literature search was March 7, 2020. Randomized controlled trials (RCTs) about using a Dachaihu decoction for HLAP were included in this study. Meta-analysis was performed by synthesizing outcome data, including total effective rate, abdomen pain relief time, first bowel movement time, blood amylase recovery time, and triglyceride (TG) levels (mmol/L). The selected literature was assessed using Cochrane’s risk of bias (RoB). Results: Twelve of 44 RCTs met the inclusion criteria. Most studies were evaluated with RoB as having unclear risk. The total effective rate of herbal medicine treatment based on the Dachaihu decoction was significantly higher than that of symptomatic supportive treatment in 10 articles (risk ratio=1.15, 95% CI: 1.08 to 1.21, p<0.00001, I2=0%). Herbal medicine treatment based on a Dachaihu decoction was significantly more effective than symptomatic supportive treatment in terms of reducing abdomen pain relief time (in all articles; mean difference=-1.70, 95% CI: -1.91 to -1.41, p<0.00001, I2=45%), first bowel movement time (in 7 articles; mean difference=-1.46, 95% CI: -1.86 to -1.05, p<0.00001, I2=73%), blood amylase recovery time (in 8 articles; mean difference=-1.48, 95% CI: -2.04 to -0.92, p<0.00001, I2=90%), and TG levels (in 8 articles; mean difference=-1.59, 95% CI: -2.28to -0.91, p<0.00001, I2=90%). Only one article reported side effects of treatment among the intervention group and control group, citing pancreatic ulcer and pancreatic pseudocyst formation. Conclusions: This study suggests that herbal medicine treatment based on a Dachaihu decoction could yield higher efficacy for HLAP than symptomatic supportive treatment alone. However, the results might be somewhat biased because of the poor quality and small sample size of the included RCTs. Well-qualified clinical studies are needed to prove the effectiveness of Dachaihu decoction therapy for HLAP.

Abstract

Objectives: The aim of this study is to investigate the effect of a Dachaihu decoction for hyperlipidemic acute pancreatitis (HLAP) by systematic review and meta-analysis of Chinese clinical studies. Methods: China National Knowledge Infrastructure (CNKI) was utilized as the major search engine. The date of the literature search was March 7, 2020. Randomized controlled trials (RCTs) about using a Dachaihu decoction for HLAP were included in this study. Meta-analysis was performed by synthesizing outcome data, including total effective rate, abdomen pain relief time, first bowel movement time, blood amylase recovery time, and triglyceride (TG) levels (mmol/L). The selected literature was assessed using Cochrane’s risk of bias (RoB). Results: Twelve of 44 RCTs met the inclusion criteria. Most studies were evaluated with RoB as having unclear risk. The total effective rate of herbal medicine treatment based on the Dachaihu decoction was significantly higher than that of symptomatic supportive treatment in 10 articles (risk ratio=1.15, 95% CI: 1.08 to 1.21, p<0.00001, I2=0%). Herbal medicine treatment based on a Dachaihu decoction was significantly more effective than symptomatic supportive treatment in terms of reducing abdomen pain relief time (in all articles; mean difference=-1.70, 95% CI: -1.91 to -1.41, p<0.00001, I2=45%), first bowel movement time (in 7 articles; mean difference=-1.46, 95% CI: -1.86 to -1.05, p<0.00001, I2=73%), blood amylase recovery time (in 8 articles; mean difference=-1.48, 95% CI: -2.04 to -0.92, p<0.00001, I2=90%), and TG levels (in 8 articles; mean difference=-1.59, 95% CI: -2.28to -0.91, p<0.00001, I2=90%). Only one article reported side effects of treatment among the intervention group and control group, citing pancreatic ulcer and pancreatic pseudocyst formation. Conclusions: This study suggests that herbal medicine treatment based on a Dachaihu decoction could yield higher efficacy for HLAP than symptomatic supportive treatment alone. However, the results might be somewhat biased because of the poor quality and small sample size of the included RCTs. Well-qualified clinical studies are needed to prove the effectiveness of Dachaihu decoction therapy for HLAP.

참고문헌 (38)

  1. 김홍자, "고중성지방혈증 급성췌장염의 최신 지견", 대한내과학회지, 93(6), pp.518~524 (2018), 대한내과학회
  2. Adiamah A, "A Systematic Review of the Epidemiology, Pathophysiology and Current Management of Hyperlipidemic Pancreatitis", Clin nutr, 37(6), pp.1810~1822 (2018)
  3. Wan J, "Stratified Analysis and Clinical Significance of Elevated Serum Triglyceride Levels in Early Acute Pancreatitis : A Retrospective Study", Lipids Health Dis, 16(1), pp.124~ (2017)
  4. Havel RJ, "Pathogenesis, Differentiation and Management of Hypertriglyceridemia", Adv Intern Med, 15, pp.117~154 (1969)
  5. Vipperla K, "Clinical Profile and Natural Course in a Large Cohort of Patients with Hypertriglyceridemia and Pancreatitis", Clin J Gastroenterol, 51(1), pp.77~85 (2017)
  6. Rawla P, "Hypertriglyceridemia-induced Pancreatitis : Updated Review of Current Treatment and Preventive Strategies", Clin J Gastroenterol, 11(6), pp.441~448 (2018)
  7. Department of Internal Medicine of Bi's System National College of Oriental Medicine, "Internal Medicine of Bi's System", pp.437~438 (2008), Goonja
  8. 강하라, "국내외 췌장염 관련 침구치료 연구 현황", Korean Journal of Acupuncture, 35(2), pp.56~69 (2018), 경락경혈학회[DOI]
  9. 이형호, "Caerulein으로 유발된 흰쥐의 급성 췌장염에 대한 銀茴蟠葱散의 효과", 대한한방내과학회지, 34(3), pp.298~311 (2013), 대한한방내과학회
  10. 유주연, "加減大黃芒硝湯 및 그 구성약재가 Cerulein으로 유도된 생쥐의 急性 膵臟炎에 미치는 影響", 대한한방내과학회지, 36(2), pp.105~121 (2015), 대한한방내과학회
  11. 송창훈, "만성 췌장염 환자 치험 1례", 대한한방내과학회지, 28(2), pp.393~400 (2007), 대한한방내과학회
  12. 황윤경, "만성 췌장염의 한약치료에 대한 최신 임상연구 동향 - CNKI검색을 중심으로", 대한한방내과학회지, 38(1), pp.48~63 (2017), 대한한방내과학회
  13. Hur J, "Donguibogam", pp.745~1450 (2005), Yeougang
  14. 여운홍, "大柴胡湯이 고혈압과 수축혈관에 미치는 영향", 동의생리병리학회지, 19(6), pp.1573~1579 (2005), 한의병리학회
  15. 노지원, "스타틴으로 조절되지 않는 이상지질혈증 환자에게 대시호탕 복용이 미치는 영향", 대한한방내과학회지, 40(6), pp.1026~1034 (2019), 대한한방내과학회[DOI]
  16. Kim CH, "The preventive effect of Daeshiho-tang on liver damage induced by acetaminophen in the rats", J Korean Orien Med Prescription, 12(2), pp.139~154 (2004)
  17. Kim Y, "Anti-inflammatory Effect of Daesiho, a Korean traditional prescription for cerebral infarct patients", Phytother Res, 22(6), pp.829~835 (2008)
  18. 송미영, "고지방 식이 유도 비만에 대한 대시호탕 추출물의 억제 효과", 한방재활의학과학회지, 18(3), pp.41~49 (2008), 한방재활의학과학회
  19. NECA's Guidance for Undertaking Systematic Reviews and Meta-analyses for Intervention, "Kim SY", National Evidence-based Healthcare Collaborating Agency, 1~287 (2011)
  20. 이준영, "메타분석", Endocrinology and Metabolism, 23(6), pp.361~378 (2008), 대한내분비학회
  21. Li CH, "Integrated Traditional Chinese and Western Medicine in the Treatment of Hyperlipidemia Pancreatitis", Shenzhen J Integ Trad Chin West Med, 29(17), pp.7~8 (2019)
  22. Shi PH, "Modified Shanzha Dachaihu Decoction in the Treatment of Hyperlipidemic Pancreatitis 36 cases", Guangming J Chin Med, 32(19), pp.2793~2795 (2017)
  23. Wu TJ, "Clinical Study on Nasal Jejunal Tube Combined with Dachaihu Decotion in the Treatment of Hyperlipidemia Acute Pancreatitis", Asia-Pac Trad Med, 11(20), pp.80~82 (2015)
  24. Liu B, "Clinical Study on Treating Hyperlipidemic Acute Pancreatitis by Integrative Medicine", West J Trad Chin Med, 27(5), pp.96~98 (2014)
  25. Zhou PJ, "Dachaihu Decoction and Erchen Decoction Adjuvant Treatment of Hyperlipidemia Acute Pancreatitis", Health for Everyone, 11, pp.107~ (2019)
  26. Lu RT, "Effect of Oral Administration of Chinese Medicine Combined with Enema on Acute Pancreatitis with Hyperlipidemia", Chin J Mod Drug Appl, 13(16), pp.135~136 (2019)
  27. He ZJ, "Observation of Curative Effect of Dachaihu Decoction Taken Orally and Enema in the Treatment of Acute Pancreatitis with Hyperlipidemia", Shaanxi J Trad Chin Med, 37(1), pp.58~59 (2016)
  28. Sun XY, "Analysis of the Effect of Non-surgical Integration of Traditional Chinese and Western Medicine on Hyperlipidemia-induced Acute Pancreatitis", Henan J Surg, 25(6), pp.48~50 (2019)
  29. Liu B, "Clinical Study of Compound Dachaihu Decoction and Rhubarb External Application in the Treatment of Hyperlipidemia Acute Pancreatitis", J Community Med, 13(13), pp.53~55 (2015)
  30. Yang XY, "Clinical Observation on the Treatment of 22 Cases of Hyperlipidemia Acute Pancreatitis with Dachaihu Decoction", Clin J Trad Chin Med, 25(5), pp.394~396 (2013)
  31. Yang L, "The Clinical Observation on Integrated Traditional Chinese and Western Medicine in Treating Hyperlipidemic Acute Pancreatitis", Chin Med Mod Distance Edu China, 16(13), pp.124~125 (2018)
  32. Wu XM, "Clinical Observation on 40 Cases of Hyperlipidemia Acute Pancreatitis Treated by Combination of Chinese and Western Medicine", J New Chin Med, 47(4), pp.117~118 (2015)
  33. 이준규, "급성 췌장염 치료의 최신 지견", 대한소화기학회지, 66(3), pp.135~143 (2015), 대한소화기학회
  34. Speck L, "Fall von lipamia", Arch Vern Wissenschaftl Heilkunde, 1, pp.232~ (1865)
  35. Wang C, "Experimental pancreatitis and plasma lipids", Gastroenterol, 35, pp.465~ (1958)
  36. Lee YG, "A Case of Acute Pancreatitis with Hyperlipidemia", J Korean Med, 31(3), pp.414~419 (1986)
  37. Chae IS, "Sanghanronyeukjun", pp.86~130 (2000), Gomunsa
  38. 김용태, "급성췌장염의 내과 치료와 합병증 대책", 대한소화기학회지, 46(5), pp.339~344 (2005), 대한소화기학회

관련 논문AI추천

만성 췌장염의 한약 치료에 대한 최근 중의 임상 연구 동향 고찰고석재, 김민정, 박재우, 박채현대한한방내과학회 · 대한한방내과학회지2023 · 제44권 제4호급성췌장염의 전침치료에 대한 체계적 문헌 고찰장인수, 정민정, 주성민, 황현호대한한방내과학회 · 대한한방내과학회지2019 · 제40권 제4호만성 췌장염의 한약치료에 대한 최신 임상연구 동향 - CNKI검색을 중심으로김강산, 김원일, 황윤경대한한방내과학회 · 대한한방내과학회지2017 · 제38권 제1호혈청 라이페이스 상승이 있는 급성 췌장염 의증 환자 치험 1례공경환, 김도현, 남민현, 오진아대한한방내과학회 · 대한한방내과학회지2024 · 제45권 제5호加減大黃芒硝湯 및 그 구성약재가 Cerulein으로 유도된 생쥐의 急性 膵臟炎에 미치는 影響신용진, 유근정, 유주연, 이언정대한한방내과학회 · 대한한방내과학회지2015 · 제36권 제2호Caerulein으로 유발된 흰쥐의 급성 췌장염에 대한 銀茴蟠葱散의 효과김인수, 신민구, 이영수, 이형호대한한방내과학회 · 대한한방내과학회지2013 · 제34권 제3호

이 간행물의 다른 논문 (20건)

전신성 활동불능증(Systemic Exertion Intolerance Disease) 진단 기준을 바탕으로 한 만성 피로 증후군(Chronic Fatigue Syndrome) 진단 설문지 개발 및 신뢰도 평가임은진, 손창규, 장은수pp. 293-305The Effect of Adding Kami-guibi-tang to Acetylcholinesterase Inhibitor Treatment on the Cognitive Function of Mild Alzheimer's Disease Patients: Study Protocol of a Randomized, Placebo-Controlled, Double-Blind Pilot Trial김정화, 장건호, 이창우, 신희연, 박성욱, 고창남, 박정미, 김하리, 양승보pp. 326-338절패모(浙貝母)의 항염 및 진해거담 효과에 대한 실험연구김진후, 이수원, 양원경, 김승형, 박양춘, 유이란pp. 339-349항암화학요법 유발 말초신경병증에 대한 침치료의 효과 : 체계적 문헌고찰 및 메타 분석윤성우, 이지영, 김은혜, 윤지현pp. 350-361중국 및 한국 Database에서의 위식도 역류질환에 대한 반하사심탕의 효과에 대한 최근 10년간의 연구경향홍상훈, 김윤정, 정유진pp. 362-413
원문 보기