痰热清联合抗生素治疗社区获得性肺炎疗效Meta分析

Meta-analysis of clinical efficacy of Integrated treatment of Tanreqing injection combined with antibiotics in treatment of community acquired pneumonia

目的系统评价痰热清联合抗生素治疗社区获得性肺炎(community acquired pneumonia,CAP)的疗效及安全性。方法检索Pubmed、Embase、CBM、CNKI、VIP和万方等中英文数据库,对国内外公开发表的关于痰热清联合抗生素治疗CAP临床疗效的随机对照试验文献,采用Jadad质量评分法进行评价,对纳入的文献采用Rev Man 5.2.6软件进行Meta分析。结果共纳入32篇文献,共3429例患者,治疗组1747例,对照组1682例。Meta分析结果显示,痰热清联合抗生素治疗CAP在总有效率、退热时间、咳嗽咳痰消失时间、肺部啰音消失时间、胸部阴影消失时间、血中白细胞恢复正常、住院时间等方面较单纯抗生素治疗优势明显,中性粒细胞分类、C反应蛋白(CRP)指标比较无统计学差异,提示可能不是疗效监测的有效指标。结论现有的有限证据表明,痰热清联合抗生素治疗CAP总有效率高于单纯抗生素治疗CAP,且安全可靠。

Objective To evaluate the clinical efficacy and safety of Tanreqing injection combined with antibiotics in the treatment of community acquired pneumonia（ CAP）. Methods Randomized controlled trials（ RCTs） on the Tanreqing injection combined with antibiotics in the treatment of CAP were retrieved in Pubmed,EMbase,CBM,CNKI,VIP and Wanfang database. Quality of the RCTs was evaluated strictly by using the Jadad quality evaluation method,statistical analysis was performed using Cochrane Collaboration＇s Rev Man5. 2. 6 software. Results Thirty-two trials involving 3429 patients were included. 1747 patients were in treatment group and 1682 patients in control group. The results of meta-analysis showed that the effectiveness of the Tanreqing injection combined with antibiotics treatment group was superior to the pure antibiotics control group in the total effective rate,defervescence time,cough or sputum disappearing time,rales disappearing time,chest shadow（ X-rays or CT） disappearance time,WBC recovery,CRP recovery and hospitalization time etc. There was no significant difference between the two groups in neutrophils and CRP. This may be show they were not effective indexs. And the adverse reaction were few. Conclusions The Tanreqing injection combined with antibiotics in the treatment of CAP is safe and effective.