摘要
目的对喜炎平联合阿糖腺苷治疗儿童病毒性脑炎的疗效进行Meta分析。方法检索CNKI、VIP、CBM、WanFang Data、PubMed、EMbase及The Cochrane Library数据库,时限为建库至2019年5月。根据研究设定的纳入和排除标准,筛选出喜炎平联合阿糖腺苷治疗儿童病毒性脑炎的随机对照试验。采用Cochrane协作网制定的标准评价文献质量,将有效数据采用RevMan5.3软件进行Meta分析。结果共纳入9个临床对照研究,病例共1370例。Meta分析结果显示,在对症治疗基础上使用喜炎平联合阿糖腺苷较单一使用喜炎平或阿糖腺苷总有效率[RR=1.19,95%CI(1.14,1.25),P<0.00001]、总治愈率[RR=1.50,95%CI(1.34,1.69),P<0.00001]明显较高,并发症发生率、病死率及后遗症发生率更低;还可改善患儿发热、呕吐、头痛、抽搐等症状,促进意识恢复,缩短脑膜刺激征消失时间及增加T细胞亚群CD3+、CD4+、CD8+细胞数量,比较差异具有统计学意义。结论在常规治疗基础上,喜炎平联合阿糖腺苷治疗儿童病毒性脑炎疗效优于单一使用喜炎平或阿糖腺苷治疗,能明显提高临床总有效率及治愈率,降低预后不良反应,改善症状、体征,提高机体免疫功能。但纳入的文献数量及质量有限,还需开展更多大样本、高质量的随机对照试验对其疗效予以验证。
Objective To make Meta-analysis of the efficacy of Xiyanping Injection combined with adenosine in the treatment of viral encephalitis in children. Methods Search CNKI,VIP,CBM,WanFang Data,PubMed,EMbase,and The Cochrane Library database for a time limit of May 2007. According to the inclusion and exclusion criteria set in this study,randomized controlled trials of Xiyanping Injection combined with adenosine in the treatment of children with viral encephalitis were screened. The quality of the literature was evaluated using the criteria developed by the Cochrane Collaboration,and the valid data was analyzed using the RevMan5.3 software for Meta-analysis. Results A total of 9 clinical control studies were included,with a total of 1370 cases. The results of the meta-analysis showed that the total effective rate of the combination of Xiyanping Injection and adenosine in the treatment of symptomatic treatment was higher than that of the single use of Xiyanping Injection or arabinoside [RR=1.19,95% CI(1.14,1.25),P<0.00001 ],the total cure rate [RR = 1.50,95% CI(1.34,1.69),P<0.00001] was significantly higher,and the incidence of complication,mortality and sequelae was lower;it can also improve symptoms such as fever,vomiting,headache,convulsions,promote consciousness recovery,reduce meningeal irritation and increase the number of CD3+,CD4+,CD8+ cells in T cell subsets. The difference was statistically significant. Conclusion On the basis of conventional treatment,Xiyanping Injection combined with adenosine in the treatment of children with viral encephalitis is better than single treatment with Xiyanping Injection or adenosine,which can significantly improve the total clinical effective rate and cure rate,and reduce the prognosis of adverse reactions,improve symptoms and signs and improve immune function. However,the number and quality of the included literature is limited,and more large-sample,high-quality randomized controlled trials are needed to verify its efficacy.
作者
邰东梅
TAI Dongmei(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China)
出处
《辽宁中医药大学学报》
CAS
2020年第4期143-148,共6页
Journal of Liaoning University of Traditional Chinese Medicine
基金
辽宁省高等学校优秀人才支持计划(LR2015040)。
