疏风解毒胶囊联合抗生素治疗社区获得性肺炎的Meta分析与GRADE评价  

Meta-analysis and GRADE Assessment of Shufeng Jiedu Capsule( 疏风解毒胶囊) Combined with Antibiotics in Treating Community Acquired Pneumonia

作　　者：刘冉 李宣霖 王憭瑶 余学庆 余海滨 李建生[2] LIU Ranl;LI Xuanlin;WANG Liaoyao;YU Xueqing;YU Haibin;LI Jiansheng(The First Affiliatited Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450000;Henan University ot Traditional Chinese Medicine)

机构地区：[1]河南中医药大学第一附属医院 [2]河南中医药大学

出　　处：《中医杂志》2018年第19期1656-1660,共5页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(81473799);国家中医药管理局国家中医临床研究基地业务建设科研专项(JDZX2015152)

摘　　要：目的系统评价疏风解毒胶囊联合抗生素治疗社区获得性肺炎(CAP)的有效性及安全性。方法计算机检索中国知网、维普中文期刊数据库、万方数字化期刊全文数据库、中国生物医学文献数据库、Embase、PubMed、Cochrane Library,收集疏风解毒胶囊治疗CAP的随机对照研究,检索时限均为从建库至2017年10月15日。采用Rev Man.5.3软件对结局指标[包括痊愈率、咳嗽消失时间、咳痰消失时间、肺部啰音消失时间、体温稳定时间、白细胞计数(WBC)、C反应蛋白(CRP)、降钙素原(PCT)]进行Meta分析,并按照GRADE标准进行证据质量评价。结果共纳入8个随机对照试验,共计874例患者。Meta分析显示:疏风解毒胶囊联合抗生素治疗与单用抗生素相比,联合组在痊愈率、咳嗽消失时间、咳痰消失时间、肺部啰音消失时间、体温稳定时间、WBC、CRP疗效更显著(P<0.05);但两组PCT差异无统计学意义(P>0.05)。根据GRADE标准,痊愈率、咳嗽消失时间两个结局指标为中等质量证据,肺部啰音消失时间、WBC、CRP为低级质量证据。结论疏风解毒胶囊联合抗生素治疗CAP的疗效优于单用抗生素治疗,但研究的方法学质量偏低。Objective To systematically evaluate the efficacy and safety of Shufeng Jiedu Capsule（ 疏风解毒胶囊） combined with antibiotics in the treatment of community-acquired pneumonia. Methods The databases of CNKI,VIP and Wanfang,CBMdisc,Embase,PubMed,Cochrane Library,Sino Med were searched by computer,and randomized controlled trials of Shufeng Jiedu Capsule in treating CAP were collected. The search time ranged from building database to October 15,2017. Rev Man. 5. 3 software was used for meta-analysis of outcome indicators including cure rate,cough disappearance time,expectoration disappearance time,lung voice loss time,body temperature stabilization time,white blood cell count（ WBC）,C-reactive protein（ CRP）,procalcitonin（ PCT）,and the quality of evidence was assessed in accordance with the GRADE criteria. Results A total of 8 RCTs were included involving 874 patients. Meta-analysis showed that compared with antibiotics alone,Shufeng Jiedu Capsule combined with antibiotic treatment had more significant effect in cure rate,cough disappearance time,expectoration disappearance time,lung voice disappearance time,body temperature stability time,WBC,CRP（ P 〈 0. 05）; however,there was no significant difference in PCT between the two groups（ P 〉 0. 05）. According to the GRADE criteria,the two outcome indicators of cure rate and cough disappearance were medium-quality evidence,and lung voice disappearance time,WBC,and CRP were low-quality evidence. Conclusion The efficacy of Shufeng Jiedu Capsule combined with antibiotics in the treatment of CAP is better than that of antibiotics alone,but the methodological quality of the study is low.

关 键 词：社区获得性肺炎 疏风解毒胶囊 随机对照试验 META分析 GRADE评价 

分 类 号：R563.1[医药卫生—呼吸系统]