尼美舒利对照阿司匹林或复方氨基比林治疗儿童发热的Meta分析

A Meta-Analysis of Nimesulide versus Aspirin and Aminopyine for Fever in Children

目的评价尼美舒利对比阿司匹林、复方氨基比林在儿童发热治疗中的疗效和安全性。方法计算机检索Pubmed、Cochrane图书馆、CBM、CNKI、维普数据库,检索时间至2011年2月,纳入符合标准的随机对照试验,依据Cochrane系统评价方法评价文献质量,数据采用Revman 5.0.0.进行Meta分析。结果纳入13个RCT共计1 200例患者,Meta分析结果显示尼美舒利对照阿司匹林,服药1 h体温(MD=0.38,95%CI[0.21,0.55],P<0.000 1)和6 h体温(MD=1.01,95%CI[0.53,1.49],P<0.000 1)差异有统计学意义;尼美舒利对照复方氨基比林,服药1 h体温(MD=0.59,95%CI[0.19,1.00],P=0.004)和6 h体温(MD=1.60,95%CI[0.91,2.28],P<0.000 01)差异有统计学意义。结论本次研究显示,尼美舒利降温效果优于阿司匹林和复方氨基比林,但较易导致嗜睡,其他不良反应尚有待进一步研究。

Objective To evaluate the effectiveness and safety of nimesulide comparing with aspirin and aminopyrine.Methods We searched Pubmed,Cochrane Library,CBM,CNKI,VIP database in Febrary,2011.Randomized controlled trials that met the inclusion criteria were included and evaluate the quality of them according to the methods of Cochrane systematic review.Meta-analysis was performed by Revman 5.0.0.software.Results A total of 13 RCTs involving 1 200 patients were included.The result of meta-analysis showed that body temperature after 1 h treatment was significant lower with nimesulide than aspirin（MD=0.38,95%CI[0.21,0.55],P 0.000 1）and aminopyrine（MD=0.59,95%CI[0.19,1.00],P=0.004）.As for body temperature after 6 h treatment,significant difference was also found compared to aspirin（MD=1.01,95%CI[0.53,1.49],P 0.000 1）and aminopyrine（MD=1.60,95%CI[0.91,2.28],P 0.000 01）.Conclusion Current evidence suggests that nimesulide is better than aspirin and aminopyrine in reducing temperature for children with fever.In addition,nimesulide has higher chance in inducing somnolence than aspirin and aminopyrine.More studies are needed to evaluate ADR.