痰热清注射液辅助化疗治疗肺结核临床疗效及安全性的Meta分析  

Meta-analysis on Clinical Effect and Safety of Tanreqing Injection in the Adjuvant Chemotherapy for Pulmonary Tuberculosis

作　　者：熊莲[1] 岳健博 汪成琼 刘权贤 袁阳[1] 肖政[1,2] 陈玲[1,2] 

机构地区：[1]遵义医学院附属医院呼吸二科(遵义医学院附属医院重大传染性疾病循证与转化研究中心),贵州省遵义市563003 [2]遵义医学院附属医院遵义医学院循证医学中心(循证医学教育部网上合作研究中心遵义医学院分中心),贵州省遵义市563003

出　　处：《实用心脑肺血管病杂志》2017年第3期6-10,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：国家自然科学基金项目(81360002)

摘　　要：目的评价痰热清注射液辅助化疗治疗肺结核的临床疗效及安全性,为临床制定抗结核治疗方案提供科学依据。方法计算机检索万方数据知识服务平台、中国生物医学文献数据库、维普网、中国知网、ISI、PubMed、EMBase、Cochrane Library等数据库中已发表文献及中国临床试验注册中心、美国临床试验注册中心中未发表文献,筛选有关痰热清注射液辅助化疗治疗肺结核临床疗效及安全性的随机对照研究,其中化疗组患者给予单纯化疗治疗,痰热清辅助化疗组患者给予化疗联合痰热清注射液治疗。采用RevMan 5.3软件进行Meta分析。结果共纳入9篇文献,包括736例肺结核患者。Meta分析结果显示,痰热清辅助化疗组患者显效率[优势比(OR)=2.15,95%可信区间(CI)(1.43,3.24)]和总有效率[OR=3.10,95%CI(1.92,4.99)]高于化疗组,差异有统计学意义(P<0.05);两组患者有效率[OR=1.24,95%CI(0.87,1.78)]、病灶吸收率[OR=2.15,95%CI(0.48,9.62)]及痰菌转阴率[OR=1.82,95%CI(0.95,3.47)]比较,差异无统计学意义(P>0.05)。5篇文献报道了药物相关不良反应/毒副作用,主要包括头晕、失眠、恶心呕吐、食欲下降、四肢关节疼痛、瘙痒、腹痛、腹泻。结论痰热清注射液辅助化疗可有效提高肺结核患者临床疗效,但其有效改善患者临床症状及体征、促进痰菌转阴及安全性等证据尚不足。Objective To evaluate the clinical effect and safety of tanreqing injection in the adjuvant chemotherapy for pulmonary tuberculosis. Methods Computer was used to search RCTs about clinical effect and safety of tanreqing injection in the adjuvant chemotherapy for pulmonary tuberculosis, including published literatures in Wanfanng Data, CBM, VIP, CNKI, ISI, PubMed, EMBasc and Cochrane Library, unpublished literatures in Chinese Clinical Trial Registry and American Clinical Trial Registry, thereinto patients of control group received chemotherapy only,, while patients of test group received chemotherapy combined with tanreqmg rejection. RevMan 5.3 software was used to carry out the Meta - analysis. Results A total of 9literatures were inw）lved, including 736 patients with pulmonary tuberculosis. Meta- analysis results showed that, obvious effective rate （OR=2.15, 95%CI （h43, 3.24）] anti total effective rate [OR=3.10, 95%CI （1.92, 4.99）] of test group were statistically significantly higher than those of control group （ P 〈 0. 05 ） , while no statistically significant differences of effective rate [OR = 1.24, 95%CI （0.87, 1.78）], lesions absorption rate [OR =2.15, 95%CI（0.48, 9. 62）] or sputum negative conversion rate [ OR = 1.82, 95% CI （0. 95, 3.47） ] was found between the two groups （ P 〉 0. 05 ）. A total of 5 literatures reported the adverse reactions/toxic and side effects, mainly included dizziness, aypnia, nausea anti vomiting, loss of appetite, limbs joint pain, cutaneous prurilus, stomachache and diarrhea. Conclusion Tanreqing injection can effectively improve the clinical effect in the adjuvant chemotherapy for puhnonary tuberculosis, but still lack sufficient evidence to support that tanreqing injection ean effectively relive the clinical symptoms and signs, promote the sputum negative conversion or confirm the safety.

关 键 词：结核 肺 痰热清注射液 治疗结果 META分析 

分 类 号：R521[医药卫生—内科学]