痰热清注射液治疗小儿支气管肺炎疗效和安全性的系统评价  

Clinical efficacy and safety of Tanreqing injection against bronchial pneumonia in children:a systematic review

作　　者：王绚[1] 张永[1] 许静[1] 徐进[1] 

机构地区：[1]南京医科大学附属南京儿童医院,江苏南京210008

出　　处：《中国医院药学杂志》2017年第3期264-269,282,共7页Chinese Journal of Hospital Pharmacy

基　　金：南京医科大学科技发展基金面上项目(编号:2015NJMU068)

摘　　要：目的:系统评价痰热清注射液治疗小儿支气管肺炎的疗效和安全性,为临床治疗提供循证依据。方法:计算机检索Cochrane Library,Embase,Pubmed,CBM,CNKI,VIP和Wanfang等数据库,查找以痰热清注射液为干预措施治疗小儿支气管肺炎的随机对照试验(RCT),检索时限均从建库至2015年6月。研究者按照纳入与排除标准独立筛选文献、提取资料并进行方法学质量评价后,采用RevMan5.2软件进行统计分析。结果:共纳入19篇文献,合计1 943例患者。Meta分析结果显示,痰热清注射液联合西医常规疗法在临床总有效率[OR=3.76,95%CI(2.68,5.28),P<0.000 01],退热时间[MD=-1.28,95%CI(-1.51,-1.05),P<0.000 01],咳嗽消失时间[MD=-1.72,95%CI(-2.13,-1.31),P<0.000 01],肺部啰音消失时间[MD=-1.55,95%CI(-1.95,-1.15),P<0.000 01],X线片恢复正常时间[MD=-2.33,95%CI(-3.19,-1.47),P<0.000 01]及平均住院时间[MD=-1.89,95%CI(-2.65,-1.12),P<0.000 01]等方面均优于对照组。纳入的19项研究中痰热清的不良反应表现轻微,均无严重不良反应发生。结论:基于当前的临床证据,在常规治疗的基础上联用痰热清注射液治疗小儿支气管肺炎可以提高疗效,且较为安全。但由于纳入的研究质量有限,尚需设计更多严谨的、大样本的随机双盲对照试验加以验证。OBJECTIVE To systematically review clinical efficacy and safety of Tanreqing injection for treating bronchial pneumonia in children.METHODS Randomized controlled trials（RCTs）concerning Tanreqing for bronchial pneumonia in children were searched through databases such as Cochrane Library,EMbase,PubMed,CBM,CNKI,VIP and Wanfang from inception to 2015 June.Literatures were extracted according to inclusion and exclusion criteria,and methodological quality of included studies was also assessed.Meta-analysis was performed by RevMan5.2 software.RESULTS A total of 19 RCTs involving 1943 cases were included.Results of Meta-analysis showed that Tanreqing group was significantly superior to conventional therapy group in total therapeutic efficacy[OR=3.76,95%CI（2.68,5.28）,P〈0.000 01],shorter defervescence time[MD=-1.28,95%CI（-1.51,-1.05）,P〈0.000 01],cough disappearance time [MD=-1.72,95%CI（-2.13,-1.31）,P〈0.000 01],rale disappearance time [MD=-1.55,95%CI（-1.95,-1.15）,P〈0.000 01],X-ray recovery time [MD=-2.33,95%CI（-3.19,-1.47）,P〈0.000 01]and hospitalization duration [MD=-1.89,95%CI（-2.65,-1.12）,P〈0.000 01].Adverse drug reactions of Tanreqing were mild without serious outcomes.CONCLUSION Actual clinical evidence indicates that efficacy and safety of Tanreqing combined with conventional therapy are superior to treat bronchial pneumonia in children.However,reliability of systematic review is affected by low quality of included studies.More rigorously designed and large-scale RCTs should be carried out for further validation.

关 键 词：痰热清注射液 支气管肺炎 小儿 系统评价 META分析 

分 类 号：R969[医药卫生—药理学]