High retention enema with traditional Chinese medicine for post-ERCP pancreatitis: a Meta-analysis
GAO Xia，WANG Lin-heng，MENG Jie
Abstract:
Objective This study systematically evaluated the efficacy and safety of high retention enema with traditional Chinese medicine(TCM) for preventing post-endoscopic retrograde cholangiopancreatography pancreatitis(PEP). Methods The PubMed, The Cochrane Library, EMbase, CNKI, VIP, WanFang and SinoMed database were retrieved from the time of database establishment to December 9, 2022 to collect randomized controlled trials (RCTS) on the efficacy and safety of high retention enema with TCM for preventing PEP. According to the inclusion and exclusion criteria, two researchers independently conducted literature screening, data extraction and bias risk assessment, and then the meta -analysis was conducted with Stata15 software. Results A total of 6 RCTs involving 579 patients were included. The results of meta-analysis showed that, compared with routine Western medicine treatment, high retention enema with TCM could reduce the incidence of PEP(OR=0.27，95%CI[0.13，0.54]，P＜0.001) and post-ERCP hyperamylasemia(PEH)(OR=0.29，95%CI[0.19，0.44]，P＜0.001), decrease the level of amylase (AMS) at 3 hours(SMD=-0.51，95%CI[-0.85，-0.17]，P=0.003), 6 hours(SMD =-1.15，95%CI[-1.72，-0.59]，P＜0.001), 12 hours(SMD =-0.69，95%CI[-0.98，-0.40]，P=0.003) and 24 hours(SMD =-1.91，95%CI[-3.16，-0.66]，P=0.003) after ERCP, decrease the level of interleukin-6(IL-6) at 24 hours after operation(SMD =-1.26，95%CI[-1.61，-0.91]，P＜0.001), shorten the hospitalization time(SMD =-1.13，95%CI[-1.70，-0.56]，P＜0.001) and save the hospitalization expenses(SMD =-0.41，95%CI[-0.75，-0.07]，P=0.017). Conclusions High retention enema with TCM was effective and safe in preventing PEP, and it could shorten the hospitalization time and reduce the hospitalization cost. Influenced by the quality of included literature, the above conclusions need to be verified by more high-quality clinical studies.
