中药注射剂治疗病毒性肺炎的系统评价再评价

Chinese herb injections for viral pneumonia:an overview of systematic reviews

目的对中药注射剂治疗病毒性肺炎的系统评价进行再评价。方法计算机检索CNKI、CBM、WanFang Data、VIP、PubMed、Web of Science、The Cochrane Library和EMbase数据库,搜集中药注射剂治疗病毒性肺炎的系统评价,检索时限均为建库至2020年3月。由2名研究者独立筛选文献、提取资料后,采用AMSTAR 2评价纳入系统评价的方法学质量,使用GRADE系统对结局指标进行证据质量分级。结果共纳入10个系统评价,包含6种中药注射剂(喜炎平注射液、炎琥宁注射液、痰热清注射液、热毒宁注射液、双黄连注射液、穿琥宁注射液)。AMSTAR 2评价结果显示,有5个条目报告较为完整,2个条目未报告,总体质量不高。中药注射剂疗效在退热时间、肺部啰音消失时间、临床总有效率等方面多优于西药,GRADE评价结果显示证据质量为中等质量到极低质量。结论现有证据显示,中药注射剂治疗病毒性肺炎的系统评价方法学质量有待提高。多数结果显示中药注射剂疗效优于西药。

Objectives To overview the systematic reviews of traditional Chinese herb injections for viral pneumonia.Methods CNKI,CBM,WanFang Data,VIP,PubMed,Web of Science,The Cochrane Library and EMbase databases were electronically searched to collect systematic reviews(SRs)of traditional Chinese herb injections for viral pneumonia from inception to March 2020.Two reviewers independently screened literature and extracted data.Then,AMSTAR 2 was used to assess the methodological quality and GRADE was used to grade the outcome indicators of included SRs.Results A total of 10 SRs were included,containing six Chinese herb injections(Xiyanping injection,Yanhuning injection,Tanreqing injection,Reduning injection,Shuanghuanglian injection,and Chuanhuning injection).Five items of AMSTAR 2 were reported well,and two items were not reported in any of the included SRs,and the quality was unsatisfactory.The efficacy of Chinese herb injection was superior than that of western medicine in many outcome indicators,such as antipyretic time,the pulmonary rales disappearing time,and the total clinical efficiency.The quality of evidence ranged from medium to very low.Conclusions Current evidence shows that the quality of SRs of Chinese herb injections for viral pneumonia requires improvement,and most of the results show that Chinese herb injections are more effective than western medicines.