射干麻黄汤治疗小儿咳嗽变异性哮喘的Meta分析

Efficacy of Shegan Mahuang Decoction on Cough Variant Asthma in Children:A Meta-Analysis

目的:系统评价射干麻黄汤(Shegan Mahuang decoction)治疗小儿咳嗽变异性哮喘的临床疗效。方法:计算机检索美国国立医学图书馆(Pubmed)、中国期刊全文数据库(CNKI)、维普中文科技期刊数据库(VIP)、万方数字化期刊全文数据库(WanFang Data),查找关于射干麻黄汤与西药对比治疗小儿咳嗽变异性哮喘的随机对照试验。由2名评价者独立对纳入研究的质量进行严格评价和资料提取后,采用Revmen5.1软件进行Meta分析。结果:共纳入8个随机对照试验,合计850例患儿。Meta分析结果显示:与西医治疗比较,射干麻黄汤可以显著提高有效率[OR=5.24,95%CI(3.51,7.83),P<0.000 01];其次,射干麻黄汤可以明显降低肿瘤坏死因子-α(TNF-α)含量[SMD=-1.26,95%CI(-2.37,-0.15),P=0.03],其差异均有统计学意义。结论:射干麻黄汤治疗小儿咳嗽变异性哮喘临床有效,并且可以显著降低TNF-α的含量。然而,现有小样本的随机对照试验(RCT)方法学和报告质量较低,疗效的证据需要迸一步大样本严格设计的临床试验证实。

Objective： To systematically evaluate the efficacy of Shegan Mahuang decoction versus western medicine on cough variant asthma in children.Method： Pubmed,CNKI,VIP,WanFang Data were researched for the randomized controlled trials（RCTs） of Shegan Mahuang decoction for cough variant asthma in children.Two reviewers evaluated the quality of the included RCTs and extracted data criticallyand independently,and then the extracted data were analyzed by using RevMan 5.1 software.Result： Eight RCTs involving 850 patients entered the inclusion criteria.The results of meta-analyses showed that compared with Western medicine treatment,Shegan Mahuang decoction could increase the total effective rate [OR = 5.24,95% CI（3.51,7.83）,P 0.000 01 ];Shegan Mahuang decoction could decrease the total content of tumor necrosis factor-α（TNF-α） [SMD =-1.26,95%CI（-2.37,-0.15）,P =0.03],significant differences.Conclusion： The current evidence shows that Shegan Mahuang decoction is effective in treatment cough variant asthma in children,and can significantly reduce the content of tumor necrosis factor-α（TNF-α.） However,the quality of methodology and report of small sample of RCT is lower,and the curative effect of Shegan Mahuang decoction needs to be approved further by strict designed clinical trials with large sample.