4种中药注射液治疗病毒性肺炎的疗效分析:一项网状Meta分析研究  

Comparative Efficacyof Four Chinese Herbal Injections for Treating Virus Pneumonia: A Network Meta-Analysis of Randomized Controlled Trials

作　　者：孙亚磊 袁斌[1] SUN Yalei;YUAN Bin(Department of Pediatrics,Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,Jiangsu,China)

机构地区：[1]南京中医药大学附属医院儿科,江苏南京210029

出　　处：《中华中医药学刊》2020年第7期113-120,I0016,共9页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金(81873340);国家中医药管理局中医药循证能力建设项目(2019X ZZX-EK 003);江苏省研究生科研与实践创新计划项目(KYCX19_1211)。

摘　　要：目的运用网状Meta分析的方法比较穿琥宁注射液、炎琥宁注射液、喜炎平注射液、痰热清注射液治疗病毒性肺炎的疗效与安全性。方法检索建库至2018年10月31日的PubMed、Embase、Cochrane Library、CBM、CNKI、Wan Fang,VIP数据库收录的关于穿琥宁注射液、炎琥宁注射液、喜炎平注射液、痰热清注射液治疗病毒性肺炎的随机对照试验(RCT)相关文献。干预措施及类型为:中药注射液与西药抗病毒类药物治疗病毒性肺炎比较的RCT。按Cochrane系统评价手册中关于RCT质量评价方法评价纳入文献质量,并运用网状Meta分析的方法比较中药注射液治疗病毒性肺炎的疗效与安全性。结果纳入67篇有效文献共7145例患者,所纳入研究文献质量相对偏低。网状Meta分析结果显示:在临床有效率方面,喜炎平注射液成为治疗的最佳选择的可能性最大(SUCRA=0.823),其次是痰热清注射液(SUCRA=0.720)。在体温恢复正常时间的比较中,根据SUCRA值可以得出最有可能成为最佳治疗措施的是喜炎平注射液(SUCRA=0.835)。喜炎平注射液在咳嗽消失时间指标的比较中也是最有可能成为最佳治疗措施的选择(SUCRA=0.893)。在对于消除肺部罗音的疗效比较中,穿琥宁注射液SUCRA值最大(SUCRA=0.870),故优先推荐穿琥宁注射液为最佳的用药选择。结论喜炎平注射液在病毒性肺炎的治疗中显示出了最优的临床疗效,但因本次研究纳入文献质量相对偏低,故需要更多高质量RCT研究加以验证本结论。Objective To evaluate the clinical efficacy and safety of Chuanhuning Injection,Yanhuning Injection,Xiyanping Injection and Tanreqing Injection in the treatment of virus pneumonia.Methods Randomized controlled trials involving Chuanhuning Injection,Yanhuning Injection,Xiyanping Injection and Tanreqing Injection in the treatment of virus pneumonia were identified from CBM database,CNKI database,Wan Fang database,VIP database,EMbase and PubMed.We included randomized controlled trials to test four Chinese herbal injections versus western medicine.The methodological quality of trials was evaluated with Cochrane Handbook criteria,and the WinBUGS version 1.4.3 software and STATA version 12.0 software were used for network Meta-analysis.Results A total of 67 RCTs with 7145 participants were included in the study.The surface under the cumulative ranking area results suggested that Xiyanping Injection and Tanreqing Injection had relatively high ranking in clinical effective rate.On account of the second outcomes:Xiyanping Injection had a better efficacy than others with respect to the time of cough subsided.In terms of the time of body temperature recovery,Xiyanping Injection exhibited better performance with the highest SUCRA values of 0.835.As can be observed,available evidence suggested that Chuanhuning Injection could better reduce the time of lung rales disappearing.Conclusion Xiyanping Injection exhibited the best performance for the treatment of viral pneumonia.Given limited evaluating of results,more well-designed trials are clearly warranted.

关 键 词：病毒性肺炎 穿琥宁注射液 炎琥宁注射液 喜炎平注射液 痰热清注射液 网状Meta分析 

分 类 号：R259.631[医药卫生—中西医结合]