口服中成药治疗儿童支气管肺炎的网状Meta分析  

Network Meta-analysis of oral Chinese patent medicine in treatment of children with bronchopneumonia

作　　者：李毓赟 李阳 王瑞杰 刘东德 庞稳泰 张冬 张国骏[1] LI Yu-yun;LI Yang;WANG Rui-jie;LIU Dong-de;PANG Wen-tai;ZHANG Dong;ZHANG Guo-jun(College of traditional Chinese medicine,Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China;Evidence-Based Medicine Center,Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China)

机构地区：[1]天津中医药大学中医学院,天津301617 [2]天津中医药大学循证医学中心,天津301617

出　　处：《中草药》2022年第1期176-195,共20页Chinese Traditional and Herbal Drugs

基　　金：天津市中医药重点领域科技项目:中医药防治新冠肺炎证据库建立与循证评价研究(2021002)。

摘　　要：目的基于网状Meta分析方法评价不同口服中成药治疗儿童支气管肺炎的疗效及安全性,为儿童支气管肺炎的临床用药提供循证依据。方法计算机检索中国知网(CNKI)、万方(Wanfang)、维普(VIP)、PubMed、Cochrane Library、Web of Science等数据库,检索有关口服中成药治疗儿童支气管肺炎的临床随机对照试验(randomized controlled trial,RCT),检索时限为各数据库建库至2021年8月4日。采用Cochrane推荐的偏倚风险评估工具对纳入的RCT进行质量评价。应用Rev Man5.4进行传统Meta分析,R软件和Ge MTC进行贝叶斯模型网状Meta分析。结果最终纳入文献106篇,均为中文文献,总样本量13 005例,其中试验组6599例,对照组6406例,涉及16种口服中成药。网状Meta分析结果表明,在临床总有效率方面,复方鱼腥草颗粒疗效最为显著,其次为小儿定喘口服液和鱼腥草合剂;在咳嗽消失时间方面,小儿咳喘灵颗粒/口服液疗效最为显著,其次为小儿肺热咳喘颗粒/口服液和肺炎合剂;在退热时间方面,金振口服液疗效最为显著,其次为复方鱼腥草颗粒和小儿咳喘灵颗粒/口服液;在肺部啰音消失时间方面,小儿咳喘灵颗粒/口服液疗效最为显著,其次为肺炎合剂和小儿消积止咳口服液。在不良反应事件方面,多数研究仅报道了轻度的胃肠道反应,各干预措施均未出现严重的不良反应事件。结论将临床总有效率排序结果作为临床选择用药依据,由此得出复方鱼腥草颗粒、小儿定喘口服液、鱼腥草合剂、小儿咳喘灵颗粒/口服液、金振口服液5种口服中成药成为治疗儿童支气管肺炎最优方案的可能性最大。由于纳入研究方法学质量偏低,结论仍有待高质量的研究加以验证。Objective To evaluate the efficacy and safety of different oral Chinese patent medicine in the treatment of children with bronchopneumonia based on network Meta-analysis,in order to provide evidence for clinical medication of bronchopneumonia.Methods The clinical randomized controlled trials(RCT)of oral Chinese patent medicine in the treatment of children with bronchopneumonia were searched from the databases of CNKI,Wanfang,VIP,Pub Med,Cochrane Library,and Web of Science from the establishment of each database to August 4,2021.The quality of the included RCTs was evaluated using the Cochrane recommended bias risk assessment tool.Rev Man 5.4 was used for pairwise Meta-analysis,R project and Ge MTC were used for network Meta-analysis.Results A total of 106 RCTs were included,all of which were Chinese,with a total sample size of 13005 cases,including 6599 cases in the experimental group and 6406 cases in the control group,involving 16 oral Chinese patent medicines.The results of network Meta-analysis showed that in terms of clinical total effective rate,Compound Houttuynia Granule(复方鱼腥草颗粒)was the most effective,followed by Xiaoer Dingchuan Oral Liquid(小儿定喘口服液)and Houttuynia Mixture(鱼腥草合剂);In terms of cough disappearance time,Xiaoer Kechuanling Granule/Oral Liquid(小儿咳喘灵颗粒/口服液)was the most effective,followed by Xiaoer Feire Kechuanling Granule/Oral Liquid(小儿肺热咳喘颗粒/口服液)and Pneumonia Mixture(肺炎合剂);In terms of fever disappearance time,Jinzhen Oral Liquid(金振口服液)was the most effective,followed by Compound Houttuynia Granule and Xiaoer Kechuanling Granule/Oral Liquid;In terms of the disappearance time of lung rale,the curative effect of Xiaoer Kechuanling Granule/Oral Liquid was the most significant,followed by Pneumonia Mixture and Xiaoer Xiaoji Zhike Oral Liquid(小儿消积止咳口服液).In terms of adverse reaction events,most studies only reported mild gastrointestinal reactions,and no serious adverse reaction events oc

关 键 词：口服中成药 儿童 支气管肺炎 网状Meta分析 肺炎合剂 复方鱼腥草颗粒 金振口服液 小儿定喘口服液 小儿肺热咳喘颗粒/口服液 小儿咳喘灵颗粒/口服液 小儿消积止咳口服液 鱼腥草合剂 

分 类 号：R285.64[医药卫生—中药学]