痰热清注射液治疗血液肿瘤并肺部感染有效性及安全性的Meta分析

Efficacy and safety of Tanreqing treatment for pulmonary infection after hematologic tumor: a Meta-analysis

目的系统分析痰热清注射液治疗血液肿瘤合并怖部感染的有效性与安全性，为制订临床治疗策略提供依据。方法系统检索CBM、CNKI、维普、万方、Pubmed及Embase数据库，采用Coehrane协作网RCT质量评价标准评价纳入研究质量，Meta分析对提取的数据进行分析。结果纳入4个随机对照研究，血液肿瘤并怖部感染335例，痰热清注射液治疗组175例，抗生素治疗组160例，纳入研究质量一般；Meta分析合并OR或MD值分别为临床总体疗效1．05（0．92～1．20）、临床治愈0．93（0．68～1．26）、临床显效1．33（0．73～2．42）及临床有效1．00（0．74～1．33）、平均退热时间-0．06（-0．38～0．26）、平均怖部哕音消失时间0．21（-0．33～0．75）、怖部阴影缓解时间0．18（-0．19～0．54）、细菌阳性率1．02（0．45～2．33）及细菌清除率0．95（0．77～1．17），指标差异均无统计学意义（P〉0．05）。结论单独使用痰热清注射液治疗血液肿瘤并怖部感染的临床疗效、症状体征缓解及细菌清除效果较好，可能与单独使用抗生素效果相当，安全性较好，但尚需高质量证据予以进一步证实。

Objective To systematically review all related studies about Tanreqing for pulmonary infection after hematologic tumor and analyse its effectiveness and safety in order to provide the evidence for the clinical strategies. Methods We retrieved all related studies in CBM, CNKI, VIP, Wanfang, Pubmed and Embase and evaluated the quality of all included studies by Cochrane scale and analyzed all data by Meta-analysis. Results Four RCTs involving 335 hematologic tumor patients were included, with general methodological quality in most trials. The merged OR or MD values and their 95％ CI of Meta-analysis for clinical overall effect, cure, marked effectiveness and effec-tiveness, the antipyretic time, the rale disappear time, the lung shadow disappear time, the bacteria positive rate and the bacterial clearance were as follows:1. 05(0. 92~ 1. 20), 0. 93(0. 68 ~1. 26),1. 33(0. 73 ~2. 42),1. 00(0. 74 ~1. 33),-0. 06( -0. 38 ~0. 26),0. 21 ( -0. 33~0. 75),0. 18( -0. 19~0. 54),1. 02(0. 45~2. 33)and 0. 95(0. 77~1. 17). The difference between these factors was no statisti-cally significant. Conclusion Our study confirms that the clinical effect, symptoms relief effect and bacterial clearance rate of Tanreqing may be as good as those of the antibiotic to pulmonary infection after hematologic tumor. It is also safe. However, all need to be further con-firmed by high quality evidence.