细辛脑注射液治疗呼吸系统疾病的Meta分析

Asarone Injection in Treating Respiratory Disease: A Meta-analysis

目的系统评价细辛脑注射液治疗呼吸系统疾病的有效性。方法计算机检索MEDLINE(1990～2010)、EMbase(1990～2010)、中文科技期刊全文数据库(1989～2010.1)、中国期刊全文数据库(1979～2009.12),收集有关细辛脑注射液治疗呼吸系统疾病的随机对照试验。由两名评价员独立地对纳入文献进行资料提取、质量评价并交叉核对,而后采用RevMan5.0软件进行Meta分析。结果共纳入文献29篇,包括3-931例患者。Meta分析结果显示:①细辛脑注射液可有效治疗毛细支气管炎、慢性阻塞性肺疾病(COPD)及其急性加重期,以及支气管炎、肺炎等呼吸系统疾病。②在治疗毛细支气管炎方面,细辛脑注射液总有效率优于氨茶碱、鱼腥草、病毒唑,与穿琥宁的疗效相似。③在治疗COPD及其急性加重期方面,细辛脑注射液总有效率优于COPD对症治疗、溴己新,与青霉素钠、复方甘草片疗效相似,其总有效率不如氨茶碱,但差异无统计学意义。④在治疗支气管炎方面,细辛脑注射液总有效率优于氨茶碱以及支气管炎的一般对症治疗,与沐舒坦疗效相似。⑤在治疗肺炎方面,细辛脑注射液总有效率优于抗生素、利巴韦林及氨茶碱。结论细辛脑注射液可有效治疗呼吸系统疾病。但由于纳入研究的方法学质量较低,可能存在发表性偏倚,因此需要进行更多高质量、大规模的临床随机对照研究,以便更客观、全面、正确地评价其疗效。

Objective To evaluate the efficacy of asarone injection in treating respiratory disease. Methods All the randomized controlled trials （RCTs） about treating respiratory disease with asarone injection were collected by searching MEDLINE （1990 to 2010）, EMbase （1990 to 2010）, CSJD （1989 to January 2010） and CNKI （1979 to December 2009）. The assessment of methodological quality and data extraction of the included studies were performed independently by two reviewers, and Meta-analysis was conducted with RevMan 5.0 software. Results A total of 29 studies involving 3-931 patients met the inclusion criteria. The results of Meta-analysis showed that： a） Asarone injection was effective in treating respiratory diseases including bronchiolitis, chronic obstructive pulmonary diseases （COPD） and AECOPD, bronchitis and pneumonia; b） In treating bronchiolitis, asarone injection was superior to aminophylline, heartleaf houttuynia herb and virazole in total effective rate, and was similar to andrographolide in curative effect; c） In treating COPD and AE-COPD, asarone injection was superior to symptomatic treatment and bromhexine in total effective rate, was similar to benzylpenicillin sodium and tablete glycyrrhiza in curative effect, and was inferior to aminophylline in total effective rate without signi cant di erence; d） In treating bronchitis, asarone injection was superior to aminophylline and symptomatic treatment in total effective rate, and was similar to mucosolvin in curative effect; and e） In treating pneumonia, asarone injection was superior to antibiotic, ribavirin and aminophylline in total effective rate. Conclusion Asarone injection is effective in treating respiratory disease. Because of the lower methodological quality and publication bias of the included trials, it is necessary to perform more high-quality and large-scale randomized controlled trials to make the conclusion more reliable.