连花清瘟胶囊治疗流行性感冒疗效和安全性的系统评价  

Effectiveness and Safety of Lianhuaqingwen Capsule for Influenza:A Systematic Review

作　　者：蔡林利[1] 蒋红丽[1] 樊涛[1] 钟云青[1] 周维[1] 毛兵[1] 

机构地区：[1]四川大学华西医院,成都610041

出　　处：《中国循证医学杂志》2012年第11期1396-1403,共8页Chinese Journal of Evidence-based Medicine

基　　金：2010四川省科技厅支撑计划(编号:2010SZ0165)

摘　　要：目的系统评价中成药连花清瘟胶囊治疗流行性感冒的临床疗效和安全性。方法计算机检索MEDLINE(Ovid)、The Cochrane Libary、PubMed、VIP、WanFang Data、CNKI和CBM,收集连花清瘟胶囊治疗流行性感冒的随机对照试验(RCT),检索时限均为2000～2011年。按纳入和排除标准筛选试验、提取资料并评价研究质量后,采用RevMan 5.0软件进行统计分析。结果共纳入12个RCT,其中中文11篇,英文1篇,按治疗策略分层进行Meta分析,结果显示:①连花清瘟胶囊组与其他中药治疗组比较共纳入5个RCT,连花清瘟胶囊与羚羊感冒胶囊比较,临床疗效愈显率[RR=1.32,95%CI(1.15,1.52)]、体温疗效愈显率[RR=1.31,95%CI(1.10,1.55)]及退热时间[WMD=–3.98,95%CI(–4.81,–3.15)]差异均有统计学意义;与苦甘颗粒比较,临床疗效愈显率[RR=1.33,95%CI(1.08,1.64)]及体温疗效愈显率[RR=1.58,95%CI(1.20,2.09)]差异均有统计学意义;与中药汤剂比较,退热时间差异也有统计学意义[WMD=5.52,95%CI(0.32,10.72)]。②连花清瘟胶囊组与西药治疗组比较共纳入9个RCT,其中与利巴韦林比较,临床疗效愈显率差异有统计学意义[RR=1.52,95%CI(1.15,2.02)];与磷酸奥司他韦比较,临床疗效愈显率差异无统计学意义[RR=0.96,95%CI(0.77,1.18)],而除病毒核酸转阴时间差异无统计学意义外,在退热,咳嗽、咽痛、周身酸痛、咳痰及头痛等流感样症状缓解方面均有统计学意义。所有纳入研究均未报道与连花清瘟胶囊有关的严重不良反应。结论在流行性感冒的治疗中,连花清瘟胶囊较其他中药及西药更能缓解流感样症状。由于纳入研究数量限制,上述结论尚需进一步开展更多高质量、大样本RCT加以验证。Objective To systematically review the clinical effectiveness and safety of Lianhuaqingwen capsule in the treatment of influenza. Methods Databases including MEDLINE, The Cochrane Library, PubMed, VIP, WanFang Data, CNKI and CBM were searched to collect the randomized controlled trials （RCTs） on Lianhuaqingwen capsule treat- ing influenza published from 2000 to 2011. The studies were screened according to the inclusion and exclusion criteria, the data were extracted, the quality of the included RCTs was assessed, and meta-analysis was performed using RevMan 5.0 software. Results Among !.2 RCTs included, 11 were in Chinese and 1 was in English. The results of meta-analyses based on stratified therapeutic strategies showed that： a） Lianhuaqingwen caspule vs. other traditional Chinese medicinals （TCM）： A total of 5 RCTs were included. Compared with the Lingyangganmao capsule, significant differences were found in the clinically marked effective rate （RR=l.32, 95%CI 1.15 to 1.52）, the marked effective rate of temperature （RR=I.31, 95%CI 1.10 to 1.55）, and the time of defervescence （RR=3.98, 95%CI -4.81 to -3.15）; compared with the Kugan granules, significant differences were found in the clinically marked effective rate （RR=1.33, 95%CI 1.08 to 1.64） and the marked ef- fective rate of temperature （RR= 1.58, 95%CI 1.20 to 2.09）; compared with the TCM decoction, the time of defervescence was significantly different （WMD=5.52, 95%CI 0.32 to 10.72）; and b） Lianhuaqingwen capsule vs. western drugs： A total of 9 RCTs were included. Compared with ribavirin, the clinically marked effective rate was significantly different （RR= 1.52, 95%CI 1.15 to 2.02）; compared with Phosphate oseltamivir, the clinically marked effective rate was not significantly differ- ent （RR=0.96, 95%CI 0.77 to 1.18）, and the WMDs （95%CI） of such indexes as the time of defervescence, the duration of cough, sore throat, myalgia, expectoration and headache, and the time of viral shedding were -4.50 （-

关 键 词：连花清瘟胶囊 流行性感冒 随机对照试验 系统评价 META分析 

分 类 号：R254.9[医药卫生—中医内科学]