痰热清注射液治疗放射性肺炎的系统评价

A Systematic Review of Tanreqing Injection in the Treatment of Radiation Pneumonitis

目的:评价痰热清治疗放射性肺炎的有效性及安全性。方法:检索2000年1月-2011年1月中国期刊全文数据库、中国生物医学文献数据库、维普和万方数据库等。由两位研究者独立提取资料和进行质量评价,采用RevMan5.0软件进行统计分析。结果:共纳入11个研究,776例患者。Meta分析结果显示:痰热清联合抗生素和激素组与抗生素联合激素组相比,两组显效有统计学意义,RR(95%CI)为1.43(1.03,1.99),P=0.04,痊愈,有效两组间无统计学意义,RR(95%CI)分别为1.20(0.68,2.09),P=0.53,0.79(0.50,1.24),P=0.30;痰热清组与抗生素联合激素组相比,痊愈、有效指标间有统计学意义,RR(95%CI)分别为2.75(1.56,4.86),P=0.0005、1.36(1.08,1.72),P=0.009,显效两组间无统计学意义,RR(95%CI)分别为1.28(0.95,1.74),P=0.11;痰热清联合抗生素组与抗生素联合激素组相比,痊愈、显效指标间有统计学意义,RR(95%CI)分别为2.41(1.46,3.98),P=0.0006、1.67(1.16,2.40),P=0.006,有效两组间无统计学意义,RR(95%CI)为0.73(0.43,1.24),P=0.25,客观指标退热天数、止咳天数、痰色变化天数各指标间有统计学意义,RR(95%CI)分别为-1.10(-2.03,-0.18),P=0.02、-1.15(-1.77,-0.53),P=0.0003、-0.83(-1.53,-0.14),P=0.02。结论:痰热清联合抗生素和激素治疗放射性肺炎的临床疗效明显,痰热清单独应用在有效率,痊愈率方面也显示出一定的优势,与抗生素联用可提高抗生素的临床疗效,增加治愈率,改善患者症状,缩短退热时间,且不良反应发生率低。

Objective： To assess the efficacy and safety of Tanreqing Injection for the treatment of radiation pneumonitis. Methods： Retrieving literatures in CNKI, CBM, VIP and WanFang database from January 2000 to January 2011 . Two researchers extracted and evaluated the quality of all the data independently. RevMan 5.0 software was used for statistical analysis. Results： E- leven kinds of studies and 776 patients were involved in this study. Meta analysis showed statistical difference for the index of marked efficacy between Tanreqing combined with antibiotic and hormone group and antibiotics combined with hormone group with the RR （95% CI） 1.43 （1.03, 1.99）, P =0. 04; No significant difference was found for the index of recovery and effective in these two groups with the RR （95% CI）I.20 （0.68, 2.09）, P=0.53; RR （95% CI ）0.79（0.50,1.24）, P=0.30 respectively. Statistical difference was observed for the index of recovery, effective between Tanreqing group and antibiotics combined with hormone group with the RR （95% CI） 2.75 （ 1.56, 4. 86）, P = 0. 0005 ; RR （95% CI ） 1.36 （ 1.08, 1.72 ）, P = 0. 009 respectively; No significant difference was found for the index of marked efficacy in these two groups with the RR （95% CI） 1.28 （0.95, 1.74）, P = 0. 11. Statistical difference was observed for the index of recov- ery and marked efficacy between Tanreqing combined with anti- biotics group and antibiotics combined with hormone group with the RR （95% CI） 2.41 （1.46, 3.98）, P =0.0006 and RR （95% CI ） 1.67 （ 1.16,2. 40） ,P =0. 006 respectively; No sig- nificant difference was found for the index of effective in these two groups with the RR （95% CI） 0. 73 （0.43, 1.24）, P =0. 25. Significant difference was observed in the fever time, day of cough , sputum color change with the RR （95% CI ） - 1.10（ -2. 03, -0. 18） ,P =0. 02; RR （95% CI ） - 1.15（ - 1.77, -0. 53）, P = 0. 0003; RR（95% CI ） -0. 83（ - 1.53, -0. ld） ,P =0. 02 respectively. Conclusion： Meta analysis based on current limited clini- cal research results preliminary shows that, Tanreqing injection combined with antibiotic and hormone has a better clinical efficacy for radiation pneumonitis than that of control group. The independent application of Tanreqing has some advantages in efficacy and cure rate. The combined use of Tanreqing and antibiotics could improve the therapeutic effect and cure rate of antibiotics, as well as amelio- rate cough and expectoration symptom, shorten the fever time with a lower probability of side reaction.