Efficary And Safety Of Low Molecular Weight Heparin/Heparin For Ulcerative Colitis:A Meta-analysis

Background and Objective:The incidence of Ulcerative Colitis(UC)is increasing year by year?At present,normal treatment,including Amino salicylic acid preparation,glucocorticoid,immunosuppressant and operation,is in poor therapeutic effect,the patients with UC often relapse,and even are with complications?According to the domestic and foreign literature research,patients with UC are in hypercoagulable state,the incidence of deep venous thrombosis and pulmonary embolism should not be ignored o This study is aimed to evaluate the effectiveness and safety of LMWH/UH in the adjuvant normal treatment of ulcerative colitis.MethodsWe searched electronically Wan fang Database,CNKI,VIP medical,PubMed?Medline database for RCTs about the low molecular weight heparin/heparin in adjuvant treatment of UC,from the database setting up to 2017.04.The keywords of chinese database are“????????”?“???????????" and the keywords of English database are"ulcerative colitis heparin"?"ulcerative colitis low molecular weight heparin".According to the inclusion and exclusion criteria related to low molecular weight heparin/heparin in adjuvant treatment of patients with ulcerative colitis literatures were screened,based on the assessment,Review Manager 5.3 software are used to analysis the efficiency and security of researches included.In terms of overall effectiveness,a subgroup analysis of the severity of the disease and the frequency of medication use was conducted.In security,subgroup analyses were performed on different adjuvant drugs,and sensitivity analysis and publication bias analysis were performed.The relative risk(RR)were used as effective measurements.through the heterogeneity test results,we select the fixed effects model(FEM)or random effect model(REM),and calculate the pooled estimates.Results:A total of 530 articles of RCTs on the LMWH/UH in normal adjuvant treatment of ulcerative colitis were searched.finally 8 articles were included,including 324 cases of patients with ulcerative colitis.The result of the Meta analysis is following:(1)the total effective rate of LMWH/UH in normal adjuvant treatment group is no significant difference to normal treatment groupRR1.15(95%CI:1.00,1.32,P<0.05);(2)there is no significant difference between the total effective rate of LMWH/UH in normal adjuvant treatment group of mild to moderate UC and the normal treatment groupRR1.05(95%CI 0.87,1.27,P>0.05).(3)the total effective rate of LMWH/UH in normal adjuvant treatment group of moderate to severe UC is superior to normal treatment group RR1.35(95%CI 1.11,1.63,P<0.05).(4)There is no significant difference in incidence of adverse reactions between two groups RR 0.65(95%CI:0.24,1.74,P>0.05),and bleeding,and allergies are the major adverse reactions,no serious adverse reactions were found.Conclusion:there is no significant difference between the total effective rate of LMWH/UH in normal adjuvant treatment group of mild to moderate UC and the normal treatment group.But the total effective rate of LMWH/UH in normal adjuvant treatment group of moderate to severe UC is superior to normal treatment group which can significantly improve the treatment efficiency.The adverse reactions rate of LMWH/UH adjuvant routine treatment group was not statistically significant compared with the conventional treatment group,and the main adverse reactions were bleeding and allergy,and there were no serious adverse reactions.