喜炎平对比利巴韦林治疗手足口病的meta评价

Meta-analysis of Xiyanping versus ribavirin in treatment of hand-foot and mouth disease

目的评价喜炎平治疗手足口病的有效性和安全性。方法计算机检索Cochrane Library、PubMed、Medline、中国生物医学数据库(CBM)、中国期刊全文数据库(CNKI)、维普数据库(VIP)和万方数据知识服务平台,收集所有喜炎平对比利巴韦林治疗手足口病的随机对照试验。由2位评价员独立筛选合格文献并提取相关信息进行分析。根据Cochrane协作网推荐的"偏倚风险评估工具"进行偏倚风险评估,用Revman5.0软件进行统计学分析。结果最终纳入24篇随机对照试验,共3 314例手足口病患儿。喜炎平组在总有效率、热退时间和疹退时间的疗效优于利巴韦林组,差异具有统计学意义(RR=1.17,95%CI:1.12~1.23;MD=-1.56,95%CI:-2.10^-1.02;MD=-1.41,95%CI:-1.90^-0.93)。两组中发生不良反应均较少,且在停药后均可恢复正常。结论目前证据表明,喜炎平治疗手足口病的疗效优于利巴韦林。

Objective To evaluate the efifcacy and safety of Xiyanping in the treatment of hand-foot and mouth disease. Methods Based on the principles and methods of Cochrane systematic reviews, Cochrane Library, PubMed, Medline, Chinese Bio-medicine Database （CBM）, China Journal Full-text Database （CNKI）, VIP database and Wanfang database were searched. All of the randomized controlled trials （RCT） of Xiyanping versus ribavirin were included. The data were extracted and evalu-ated by two reviewers independently. Risk assessment tool was used to assess the risk of bias and software Revman5.0 was used for meta-analysis. Results Twenty-four RCT and 3314 patients were included. Comparing to ribavirin, Xiyanping showed better therapeutic outcomes regarding to total effective rate, durations of fever and rash elimination （RR=1.17, 95%CI：1.12-1.23;MD=-1.56, 95%CI：-2.10-1.02;MD=-1.41, 95%CI：-1.90-0.93）. Side effects were rare in both groups and could be recovered after drug withdrawal. Conclusions The current evidence suggests that Xiyanping is superior to ribavirin in the treatment of hand-foot and mouth disease.