鱼腥草注射液治疗呼吸系统疾病有效性评价  

Efficacy of Houttuynia Cordata Injection for Respiratory System Diseases:A Meta-Analysis

作　　者：崔小花[1] 王莉[1] 李幼平[1] 邓绍林[2] 李廷谦[2] 商洪才[3] 

机构地区：[1]四川大学华西医院中国循证医学中心,成都610041 [2]四川大学华西医院,成都610041 [3]天津中医药大学,天津300193

出　　处：《中国循证医学杂志》2011年第7期786-798,共13页Chinese Journal of Evidence-based Medicine

摘　　要：目的系统评价鱼腥草注射液治疗上呼吸道感染、肺炎和呼吸道感染3种呼吸系统疾病的临床有效性,为其上市后再评价和临床合理使用提供依据。方法计算机检索PubMed、EMbase、CBM、CNKI和VIP等中英文数据库(1979～2010.12),查找相关随机对照试验和临床对照试验。由两名评价员独立选择试验和评价质量后,提取有效数据进行Meta分析。结果①共纳入53个研究,其中RCT 46个(6328例),临床对照试验7个(1153例)。纳入研究质量评分集中在2～6分,总体较差。其中24个5分,11个3分,7个4分,2个6分,9个2分。②治疗上呼吸道感染、肺炎和呼吸道感染病例共7481例(成人2520例,儿童4961例)。试验组措施为单用鱼腥草注射液或加用其他辅助治疗,对照组干预措施包括抗病毒、抗生素、抗病毒和抗生素联用、中药注射剂4大类;结局指标为总有效率和退热平均天数。③所有成人试验中,治疗上呼吸道感染时,试验组单用鱼腥草注射液,而对照组则分为抗病毒组、抗生素组和抗病毒药+抗生素组3个亚组;治疗肺炎时,对照组又分为抗病毒组和抗生素组;治疗呼吸道感染时,对照组分为抗生素组和中药注射剂组。结果显示,试验组治疗总有效率均高于各对照组,所需退热平均天数均缩短1～1.5天。④儿童试验中,3组(治疗上呼吸道感染对照为抗病毒组,治疗肺炎对照为抗生素组,治疗呼吸道感染为CMI组)结果显示,试验组与对照组比较,其差异无统计学意义,总有效率相当。其余与成人相对应的组别也显示有一定疗效。结论鱼腥草注射液治疗成人呼吸系统疾病表现出疗效较好的趋势,可达到快速退热的效果。临床使用中应注意规范合理用药,加强ADR/AE监测,仍可推荐使用。临床上儿童使用鱼腥草注射液者较多,但目前无充分证据证明其有效,建议停用该药。建议开展设计执行更严谨的新临床试验,以提供更高质量证�Objective To systematically evaluate the efficacy of Houttuynia cordata Injection（HI） in treating respiratory system diseases,such as infection of the upper respiratory tract,pneumonia and respiratory tract infection,so as to provide references for revaluation after having access to market and its rational use.Methods The literatures concerning both randomized controlled trials（RCTs） and clinical control study of HI were searched in PUBMED,EMBASE,Chinese Biomedical Disc（CBMdisc）,Chinese National Knowledge Infrastructure（CNKI）,Chinese Science and Technology Journal Full-text Database（VIP） from 1979 to December of 2010.The quality assessment and data extraction for RCTs were conducted by two reviewers independently.Meta-analyses were conducted with the Cochrane Collaboration＇s RevMan 5.0 software.Results a） Fifty-three trials including 46 RCTs and 7 non-RCTs were included,the quality grade was generally lower from 2 to 6 scores： 24 trials scored 5,11 trials scored 3,7 trials scored 4,2 trials scored 6,and the rest 9 trials scored 2;b） There were 7481 patients（2520 adult and 4961 children） with infection of the upper respiratory tract,pneumonia,or respiratory tract infection.The interventions in the treatment group were Houttuynia cordata Injection or the joint of Houttuynia cordata Injection and support measures.The control group included four categories： Antiviral,Antibiotics,the joint of Antiviral and Antibiotics,and Chinese medicine injection（CMI）.Both the total effective rate and average defervescence days were regarded as the result indexes;c） In all adult trials,when HI was used alone to treat the infection of upper respiratory tract（compared with the control group of antiviral,antibiotics,and the joint of antiviral and antibiotics）,the pneumonia（compared with the control group of antiviral,and antibiotics）,and the respiratory tract infection（compared with the control group of antibiotics,and CMI）,the differences between the treatment group and the control g

关 键 词：鱼腥草注射液 呼吸系统 有效性 META分析 

分 类 号：R259[医药卫生—中西医结合]