| Aims:To systematically review the efficacy of granulocyte and monocyte apheresis combined with medication on the treatment of ulcerative colitis.Methods : Randomized controlled trials(RCTs)comparing the efficacy of granulocyte and monocyte apheresis combined with medication and conventional medication on indUCtion and maintenance of remission in UC were electronically searched in PubMed,EMBASE,the Cochrane Library,Web of Knowledge,CBM,CNKI,VIP and WanFang Data from inception to November 30 th,2016.Two reviewers independently screened literature according to the inclusion and exclusion criteria,extracted data,and assessed methodological quality.Then meta-analysis was performed using Stata 12.0 software.Results:Nine RCTs with a total of 804 participants met the inclusion criteria.The Meta-analysis showed that there were statistical significances between granulocyte and monocyte apheresis combined with medication group and conventional medication group in total effective rate[RR=1.29,95%CI(1.13,1.47),P=0.000]and complete remission rate[RR=1.44,95%CI(1.17,1.79),P=0.001],While in terms of adverse reactions,there were no statistical significances [RR=0.45,95%CI(1.12,1.76),P=0.251].maintenance of granulocyte and monocyte apheresis combined with medication group was significantly higher than that of conventional medication group[RR=1.74,95%CI(1.38,2.20),P=0.000].Conclusions: Compared with conventional medication group,granulocyte and monocyte apheresis combined with medication could significantly increase the total effective rate,remission rate and maintenance in UC.At the same time,the incidence of adverse reaction were not significantly different between two groups.Considering the quality of this system evaluation into the literature is not high and no similar control group,Therefore,more rational,large-scale,multicenter randomized controlled trials are needed to determine the effect and safety of granulocyte and monocyte apheresis in the treatment of UC. |
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