槐杞黄颗粒联合常规对症治疗儿童反复呼吸道感染的Meta分析研究

Meta-analysis of Huaiqihuang Granules(槐芪黄颗粒) combined with conventional symptomatic treatment on recurrent respiratory tract infection in children

目的通过Meta分析,研究槐杞黄颗粒联合常规对症治疗儿童反复呼吸道感染的有效性。方法计算机检索中国期刊全文数据库(CNKI)、万方数据知识服务平台、中文科技期刊数据库(维普)、中国生物医学文献服务系统(Sino Med)以及Pub Med、EMBASE、the Cochrane Library等,收集槐杞黄颗粒对儿童反复呼吸道感染的疗效和免疫功能影响的随机对照试验研究,检索时限从建库至2018年5月。由2位研究者按照纳入与排除标准筛选文献,提取数据并参考改良Jadad量表评定文献质量后,采用Rev Man 5.3软件进行Meta分析。结果13篇采用随机对照试验研究文献中,仅有1篇文献描述了采用随机数字表法进行分组;5篇文献统计了平均病程,9篇文献记载了不良事件;11篇文献报道了总有效率,治疗组和对照组的总有效率比较,差异有统计学意义(P<0.001);9篇文献比较了治疗组和对照组的免疫球蛋白(Ig)A、Ig G和Ig M抗体水平,Ig A、Ig G抗体水平方面,治疗组均优于对照组(P<0.001),Ig M抗体水平比较,差异无统计学意义(P>0.05);3篇文献比较了治疗组和对照组的CD3^+、CD4^+、CD8^+和CD4^+/CD8^+水平差异,结果表明治疗组在提高患儿CD3^+、CD4^+T细胞方面优于对照组(P<0.01)。Meta分析通过逐一剔除文献方法进行敏感性分析,没有找到影响总体异质性的某些文献。结论槐杞黄颗粒联合常规对症治疗儿童反复呼吸道感染的总体疗效优于单纯常规对症治疗,且在改善临床症状、提高易感儿抗体水平和CD3^+、CD4^+T细胞水平方面更具优势,临床安全性较高。

Objective To evaluate the clinical efficacy of Huaiqihuang Granules combined with conventional symptomatic treatment for recurrent respiratory tract infection(RRTI)in children by Meta-analysis.Methods To search the related literatures from the databases by computer from China Academic Journal Network Publishing Database,Wanfang Data Knowledge Service Platform,VIP Database for Chinese Technical Periodicals,Sino Med,Pub Med,EMBASE and the Cochrane Library to investigate the clinical and immune effect of Huaiqihuang Granules on RRTI in children dated from inception to May,2018.The literature was screened according to the inclusion and exclusion criteria by 2 researchers.After the data were extracted and the methodological quality of studies were evaluated with reference to modified Jadad scale,the Meta-analysis was performed by the software Rev Man 5.3.Results Among 13 articles conducting randomized controlled trial,only 1 of them describing that random number table method was used for grouping;5 of them counting the mean duration of disease,9 of them recording adverse events;11 of them reported total effective rates,making comparison of total effective rates between treatment group and control group,there was statistic difference between them(P<0.001).9 of them compared the antibody levels of Ig A,Ig G and Ig M in treatment group and control group,the antibody levels of Ig A,Ig G in treatment group were superior to those in control group(P<0.001),while comparing the antibody level of Ig M,there was no statistic difference(P>0.05).3 of them compared the level differences of CD3^+,CD4^+,CD8^+and CD4^+/CD8^+in treatment group and control group,the former was superior to the latter in increasing CD3^+,CD4^+of the children(P<0.001).Meta-analysis performed sensitivity analyses by culling method,no article was found on affecting overall heterogeneity.Conclusion The overall efficacy of Huaiqihuang Granules combined with conventional symptomatic treatment on treating RRTI in children was superior to that of the conventional symptomatic treatment.It has more advantages in improving clinical symptoms,increasing the antibody levels,CD3^+,CD4^+T cell levels,and it has high security for clinical use.