中药治疗手足口病的Meta分析  

Meta Analysis on Hand-Foot-Mouth Disease Treated with Traditional Chinese Medicine

作　　者：张国梁[1] 魏超宇[1] 

机构地区：[1]安徽中医学院第一附属医院,安徽合肥230031

出　　处：《世界中西医结合杂志》2014年第2期122-125,129,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：国家中医药管理局中医药行业专项计划项目(200907001-3);安徽省科技厅计划项目(09020303110)

摘　　要：目的评价以清热解毒、化湿透疹为主要组方原则的中药方剂治疗手足口病(Hand foot and mouth disease,HFMD)的临床疗效。方法检索国内公开发表的关于中医药治疗HFMD的随机对照试验研究的文献,纳入研究的文献使用Jadad评分法进行质量评价,并对纳入文献进行疗效的Meta分析。结果 (1)17篇研究文献(n=2427)报道了中药方剂组与西药组对HFMD的临床总有效率,合并OR=4.37,95%CI为(3.11~6.13),P<0.001;(2)10篇文献(n=700)报道了退热时间,Z=4.52,SMD=-1.52,95%CI为(-2.17^-0.86),P<0.001;(3)11篇文献(n=941)报道了退疹时间,Z=5.86,SMD=-1.67,95%CI为(-2.22^-1.11),P<0.001;(4)5篇文献(n=290)报道了口腔溃疡痊愈时间,Z=5.86,SMD=-1.67,95%CI为(-2.22^-1.11),P<0.001,以上四项指标比较差异均具有统计学意义。结论中药方剂组临床总有效率、退热时间、退疹时间、口腔溃疡痊愈时间等优于西药组。退疹退热时间漏斗图提示存在发表性偏倚,受文献质量影响此结论仍须高质量临床证据进一步证实。Objective To evaluate the clinical efficacy on hand -foot -mouth disease （HFMD） treated with Chinese medicine formula based on clearing heat, removing toxin, resolving dampness and promo- ting eruption. Methods The literatures were retrieved on the randomized controlled trial studies of HFMD treated with Chinese medicine publically published in China. Jadad scale was used to evaluate the quality of the included study literatures. Meta analysis was applied on the efficacy of the included literatures. Results 1. Seventeen study literatures （n = 2427 ）reported the clinical total effective rate of HFMD in Chinese medi- cine formula group and western medicine group. OR =4.37,95% CI：3.11 to 6.13 ,P 〈0. 001 ;2. Ten litera- tures （ n = 700） reported antifebrile time,Z = 4.52, SMD = - 1.52,95% CI ： - 2.17 to - 0.86, P 〈0. 001 ; 3. Eleven literatures（ n = 941 ） reported anti - rash time, Z = 5.86, SMD = - 1.67,95% CI： - 2. 22 to - 1.11, P 〈 0.001 ;4. Five literatures （ n = 290 ） reported the healing time of mouth ulcer, Z = 5.86, SMD = -1.67,95 % CI： -2.22 to - 1.11, P 〈0. 001. The differences were significant statistically among the a- bove four indexes. Conclusion Chinese medicine formula group is superior to western medicine group in terms of total clinical effective rate,antifebrile time,anti- rash time and healing time of mouth ulcer. The fun- nel plot of the time of anti - rash and antifebrile suggests the publication bias. Due to the impacts of literature quality ,this conclusion needs to have a further proof with the consideration of high -quality clinical evidences.

关 键 词：中药组方 手足口病 临床疗效 META分析 

分 类 号：R288[医药卫生—中药学] R511[医药卫生—中医学]