中西医联合治疗儿童手足口病疗效的系统评价

System evaluation of Chinese and western medicine combined treatment of hand-foot-mouth disease

目的对公开发表的中西医联合治疗儿童手足口病的临床研究进行系统评价。方法检索PubMed、CNKI和VIP数据库,收集中西医联合治疗儿童手足口病的随机对照试验,并对纳入文献根据QUADAS量表进行质量评价和数据提取。运用Meta分析方法比较中西医结合与单纯西医治疗儿童手足口病的治愈率、退热时间和皮疹消退时间。结果共纳入11个随机对照试验,合计5 267例患者,发病年龄从3个月到14岁之间,其中中西医联合治疗3 010例,单纯西药抗病毒治疗2 257例。Meta分析结果显示,中西医联合治疗与单纯西药治疗比较,在退热时间、皮疹消退时间、治愈率方面两组差异均有统计学意义,且疗效要好于西药治疗(MD=-1.33,95%CI=-1.94^-0.72;MD=-1.78,95%CI=-2.45^-1.11;OR=1.25,95%CI=1.14~1.36)。结论在抗病毒、对症治疗的基础上加用中药汤剂治疗,对提高手足口病的治愈率、缩短退热和皮疹消退时间的作用优于常规治疗。

Objective To evaluate the Chinese and western medicine combined treatment of hand-foot-mouth disease in children. Methods A systematic review and pooled analysis were done through a meta-analysis of data obtained from the PubMed,CNKI and VIP database. The clinic studies of childhood hand-foot-mouth disease to evaluate the cure rate,the time of febrile disappeared and rash extinction were collected. Meta-analysis methods was used to evaluate the efficacy of the Chinese and western medicine combined treatment and the western medicine alone treatment for the children with hand,foot and mouth disease on the cure rate,fever and rash subsided time.And the quality of the literature was investigated according to the QUADAS scores. Results A total of 11 publications that reported the Chinese and western medicine combined treatment of hand-foot-mouth disease were collected,including 3 010 cases in Chinese and western medicine combined treatment and 2 257 cases in western medicine treatment.Chinese and western medicine combined treatment can increase the cure rate and ameliorate the time for febrile disappeared and rash extinction of hand-footmouth disease in children（MD=-1.33,95%CI=-1.94,-0.72;MD=-1.78,95%CI=-2.45,-1.11;OR=1.25,95%CI=1.14,1.36）. Conclusion The results showed that the Chinese and Western medicine treatment group was better than the control group in terms of vanishing of the rashes and effective rate.