穿心莲制剂对手足口病患儿心肌酶及肌钙蛋白转阴率影响的Meta分析  

Effects of Andrographis Paniculata Preparation on Myocardial Enzymes and Troponin Negative Conversion Rate in Children with Hand-foot-mouth Disease:a Meta-analysis

作　　者：朱雪萍 胡元会[1] 师帅[1] 袁果真 吴华芹[1] 陈婷 ZHU Xueping;HU Yuanhui;SHI Shuai;YUAN Guozhen;WU Huaqin;CHEN Ting(Guang′anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China)

机构地区：[1]中国中医科学院广安门医院,北京100053 [2]北京中医药大学

出　　处：《中西医结合心脑血管病杂志》2021年第12期1966-1973,共8页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

摘　　要：目的系统评价穿心莲制剂对手足口病患儿心肌酶谱及肌钙蛋白转阴率的影响。方法计算机检索Cochrane Library、PubMed、EMbase、中国知网、万方、维普等数据库,检索时间从建库至2020年3月1日。由两名研究者独立筛选文献、提取资料并评价偏倚风险,采用Review Manager 5.3软件进行Meta分析。结果共纳入17篇文献,涉及1800例患儿。Meta分析结果显示:试验组治疗手足口病总有效率优于对照组[OR=5.71,95%CI(4.02,8.11),P<0.00001];试验组乳酸脱氢酶水平[WMD=-29.37,95%CI(-41.33,-17.41),P<0.00001]、肌酸激酶水平[WMD=-18.49,95%CI(-26.81,-10.16),P<0.0001]、肌酸激酶同工酶水平[WMD=-5.77,95%CI(-7.81,-3.74),P<0.00001]、天冬氨酸氨基转移酶水平[WMD=-9.47,95%CI(-16.75,-2.19),P=0.01]低于对照组;试验组肌钙蛋白转阴率高于对照组[OR=12.52,95%CI(4.45,35.21),P<0.00001]。两组不良反应发生率比较,差异无统计学意义[OR=0.93,95%CI(0.52,1.67),P=0.81]。结论现有证据表明:穿心莲制剂治疗手足口病疗效明显,能有效改善患儿心肌酶谱及肌钙蛋白转阴率,且未增加不良反应。Objective To systematically evaluate the effects of Andrographis paniculata preparation on myocardial enzymes and troponin negative conversion rate in children with Hand-foot-mouth disease.Methods Cochrane Library,PubMed,EMbase,China Journal Full-Text Database(CNKI),Wanfang database,Chinese science and technology periodical database(VIP)and other databases were searched from their establishment to March 1,2020.Two researchers independently screened the literature,extracted the data and evaluated the risk of bias.Review Manager 5.3 software was used for Meta-analysis.Results A total of 17 randomized controlled trials(RCTs)were included,involving 1800 children.The results of Meta-analysis showed that the clinical efficacy in the experimental group was better than that in the control group[OR=5.71,95%CI(4.02,8.11),P<0.00001].The levels of lactate dehydrogenase(LDH)[WMD=-29.37,95%CI(-41.33,-17.41),P<0.00001],creatine kinase(CK)[WMD=-18.49,95%CI(-26.81,-10.16),P<0.0001],creatine kinase isoenzyme(CK-MB)[WMD=-5.77,95%CI(-7.81,-3.74),P<0.00001],and glutamate aminotransferase(AST)[WMD=-9.47,95%CI(-16.75,-2.19),P=0.01]in the experimental group were less than those in the control group.The troponin negative conversion rate in the experimental group was higher than that in the control group[OR=12.52,95%CI(4.45,35.21),P<0.00001].There was no significant difference in the incidence of adverse reactions between two groups[OR=0.93,95%CI(0.52,1.67),P=0.81].Conclusion Current evidence showed that Andrographis paniculata preparation was obvious curative effect in the treatment of Hand-foot-mouth disease,which could effectively improve myocardial enzyme and troponin negative conversion rate,without more adverse reactions.

关 键 词：手足口病 穿心莲 心肌酶 肌钙蛋白 META分析 

分 类 号：R54[医药卫生—心血管疾病]