摘要
目的系统评价中西医结合治疗小儿重症肺炎的疗效和安全性。方法系统检索中国期刊全文数据库(CNKI)、万方数据库、中国科技期刊全文数据库(VIP)、中国生物医学文献数据库(CKBM)中中西医结合治疗小儿重症肺炎的随机对照试验(RCT),检索时间为建库至2020年5月3日,并追索纳入研究的参考文献。应用风险评估工具评价纳入研究的质量,提取数据并采用RevMan 5.3软件进行Meta分析。结果最终纳入16项RCT,共1240例患者,其中试验组626例,对照组614例。Meta分析结果显示:试验组治疗总有效率高于对照组(RR=1.21,95%CI 1.16~1.27,P<0.00001);试验组小儿发热改善时间短于对照组(WMD=-1.59,95%CI-1.83~-1.34,P<0.00001),咳嗽改善时间短于对照组(WMD=-1.03,95%CI-1.25~-0.82,P<0.00001),肺部啰音改善时间短于对照组(WMD=-1.93,95%CI-2.17~-1.68,P<0.00001),咳痰改善时间短于对照组(WMD=-0.91,95%CI-1.24~-0.59,P<0.00001);试验组最大呼气中期流速高于对照组(WMD=0.73,95%CI 0.58~0.87,P<0.00001),两组最大呼气流量比较差异无统计学意义(WMD=0.19,95%CI-1.30~1.68,P=0.80);不良反应主要以胃肠道反应为主。结论中西医结合治疗小儿重症肺炎,在改善症状和体征、治疗总有效率、血清炎症因子指标的恢复以及肺功能改善方面均优于单纯西医治疗。
Objective To systematically evaluate the efficacy and safety of integrated traditional Chinese and western medicine in the treatment of severe pneumonia in children.Methods The randomized controlled trials(RCT)of integrated traditional Chinese and western medicine in the treatment of severe pneumonia in children were systematically searched in CNKI,Wanfang,VIP and CKBM.The retrieval time was limited from the establishment of the database to May 3rd,2020,and the references included in the studies were searched.Risk assessment tools were used to evaluate the quality of included studies.Data were extracted and Meta-analysis was performed by RevMan 5.3 software.Results A total of 16 RCTs of 1240 patients were included,including 626 patients in the test group and 614 patients in the control group.The results of Meta-analysis showed that the total response rate in the test group was higher than that in the control group(RR=1.21,95%CI 1.16-1.27,P<0.00001).The improvement time of fever in the test group was shorter than that in the control group(WMD=-1.59,95%CI-1.83--1.34,P<0.00001);the improvement time of cough in the test group was also shorter than that in the control group(WMD=-1.03,95%CI-1.25--0.82,P<0.00001);the improvement time of lung rales was shorter than that of the control group(WMD=-1.93,95%CI-2.17--1.68,P<0.00001),and the improvement time of sputum was shorter than that of the control group(WMD=-0.91,95%CI-1.24--0.59,P<0.00001).The maximum mid-expiratory flow velocity in the test group was higher than that in the control group(WMD=0.73,95%CI 0.58-0.87,P<0.00001),while there was no significant difference in the maximum expiratory flow volume between the two groups(WMD=0.19,95%CI-1.30-1.68,P=0.80).The adverse reactions were mainly gastrointestinal reactions.Conclusion In the treatment of children with severe pneumonia,the combination of traditional Chinese and western medicine is superior to the simple western medicine in improving symptoms and signs,total effective rate,recovery of serum inflammatory factors
作者
胡诗蕊
王菀
崔红生
HU Shirui;WANG Wan;CUI Hongsheng(The Third Clinical Medical College of Beijing University of Chinese Medicine,Beijing 100020,China;Department of Respiratory Medicine,the Third Affiliated Hospital of Beijing University of Chinese Medicine,Beijing 100020,China)
出处
《医学综述》
CAS
2021年第19期3929-3936,共8页
Medical Recapitulate
关键词
小儿重症肺炎
中西医结合治疗
中药汤剂口服
中药注射液
META分析
Severe pneumonia in children
Chinese and western medicine
Oral administration of traditional Chinese medicine decoction
Traditional Chinese medicine injection
Meta-analysis
