疏风解毒胶囊治疗流行性感冒疗效及安全性的系统评价与Meta分析

Systematic review and Meta-analysis of efficacy and safety of Shufeng Jiedu Capsules in treatment of influenza

系统评价疏风解毒胶囊治疗流行性感冒的疗效及安全性。系统检索PubMed、EMbase、Cochrane Library、Web of Science、中国知网(CNKI)、万方(Wanfang)、维普(VIP)、中国生物医学文献服务系统(SinoMed)8个中、英文数据库,搜索疏风解毒胶囊单独或联合常规西药治疗流行性感冒的随机对照试验(RCT),同时检索ClinicalTrails.gov。使用RevMan 5.4.1软件进行数据分析,使用Cochrane风险偏倚评估工具进行文献质量评价,使用GRADEpro GDT软件进行证据质量评估。最终纳入11篇RCTs,1 836例患者。与常规西药相比,疏风解毒胶囊或疏风解毒胶囊+常规西药可提高有效率(RR=1.09,95%CI[1.03,1.15],P=0.002),缩短咳嗽缓解时间,提高3 d咽痛缓解率,但在退热时间、咽痛缓解时间、3 d咳嗽缓解率、3 d流涕缓解率方面差异无统计学意义。亚组分析结果显示,与常规西药相比,疏风解毒胶囊+常规西药可以提高有效率(RR=1.11,95%CI[1.08,1.15],P<0.000 01),缩短咳嗽缓解时间,提高3 d咳嗽缓解率、3 d咽痛缓解率、3 d流涕缓解率,但在退热时间、咽痛缓解时间方面差异无统计学意义。单用疏风解毒胶囊未能提高有效率(RR=0.97,95%CI[0.93,1.02],P=0.19)。此外,疏风解毒胶囊或疏风解毒胶囊+常规西药与常规西药相比,不良反应差异无统计学意义(RR=0.98,95%CI[0.57,1.69],P=0.95)。结果表明,疏风解毒胶囊在治疗流行性感冒方面是有效的,且联合常规西药使用可加快症状的缓解,而且安全性较好。但由于纳入文献数量少、质量较低,上述结论仍需多中心、大样本的RCT进一步验证。

This study aims to systematically review the efficacy and safety of Shufeng Jiedu Capsules in the treatment of influenza.The randomized controlled trial(RCT) of Shufeng Jiedu Capsules alone or in combination with conventional western medicine for treating influenza were retrieved from PubMed,EMbase,Cochrane Library,Web of Science,SinoMed,CNKI,VIP,Wanfang,and ClinicalTrails.gov.The data analysis was performed in RevMan 5.4.1.The Cochrane risk of bias assessment tool was used to evaluate the quality of the involved RCT,and GRADEpro GDT to assess the quality of the evidence.A total of 11 RCTs involving 1 836 patients were included in this study.Compared with conventional western medicine,Shufeng Jiedu Capsules/Shufeng Jiedu Capsules + conventional western medicine improved the response rate(RR=1.09,95%CI[1.03,1.15],P=0.002),shortened the time to relief of cough,and increased the 3-day sore throat relief rate,whereas there was no significant difference in the time to fever abatement,the time to relief of sore throat,3-day cough relief rate,or 3-day runny nose relief rate.Subgroup-analysis showed that Shufeng Jiedu Capsules + conventional western medicine improved the response rate(RR=1.11,95%CI[1.08,1.15],P<0.000 01),shortened the time to relief of cough,and increased the 3-day relief rate of symptoms(cough,sore throat,and runny nose) compared with conventional western medicine alone,while there was no significant difference in the time to fever abatement or the time to relief of sore throat.Shufeng Jiedu Capsules alone could not improve the response rate(RR=0.97,95%CI[0.93,1.02],P=0.19).In addition,Shufeng Jiedu Capsules/Shufeng Jiedu Capsules + conventional western medicine vs conventional western medicine were no significant difference in adverse reactions(RR=0.98,95%CI[0.57,1.69],P=0.95).The available evidence suggests that Shufeng Jiedu Capsules is effective and safe in the treatment of influenza,and the combination of Shufeng Jiedu Capsules with conventional western medicine can accelerate the relief of symptoms.However,since the number and quality of the included studies were low,the above findings remained to be further verified by multicenter RCT with large sample sizes.