痰热清注射液治疗全身炎症反应综合征的系统评价

Systematic review of Tanreqing injection in treatment of systemic inflammatory response syndrome

目的系统评价痰热清注射液治疗全身炎症反应综合征的效果。方法检索Ovid/Pubmed、Embase、中国知网、万方数据知识服务平台、维普期刊资源整合服务平台、中国生物医学文献数据库,查找痰热清注射液治疗全身炎症反应综合征的随机对照试验（RCT）,观察指标包括临床总有效率、WBC、血清C-反应蛋白（CRP）、TNF-α、血清降钙素原（PCT）、体温（T）。根据Jadad质量评分法对文献质量进行评价。结果最终纳入11篇文献,共811例患者,对照组396例、痰热清组415例。纳入文献质量总体不高,仅1篇为高质量文献。纳入文献存在发表偏倚。与对照组相比,痰热清组总有效率提高（OR=3.05,95%CI：1.46~6.39,P=0.003）,WBC下降（WMD=1.39,95%CI：2.25~0.53,P=0.002）,血清CRP（WMD=13.78,95%CI：19.96~7.60,P〈0.00 01）、PCT（SMD=2.17,95%CI：4.23 0.11,P=0.04）、TNF-α（SMD=-1.50,95%CI：2.14~0.85,P〈0.00 001）、IL-6（WMD=-24.04,95%CI：36.03~12.05,P〈0.00 01）降低,T降低（WMD=-0.66,95%CI：0.85~0.47,P〈0.00 01）。所有文献未报告痰热清注射液有不良反应。结论痰热清注射液治疗全身炎症反应综合征效果较好。

Objective To evaluate the efficacy of Tanreqing injection in treatment of systemic inflammatory response syndrome（ SIRS） systematically. Methods We retrieved Ovid / Pubmed,Embase,CNKI,Wanfang data,VIP and Chinese biomedical literature database to search for the randomized controlled trial（ RCT） of Tanreqing injection in the treatment of SIRS,and then we observed the following indexes,including the clinical total effective rate,white blood cell count（ WBC）,serum C-reactive protein（ CRP） and serum tumor necrosis factor-α（ TNF-α）,serum calcitonin（ PCT） and temperature（ T）. According to the Jadad quality evaluation,we evaluated the literatures. Results Eleven trials were eligible finally,and contained 811 cases of patients including 396 patients treated with conventional treatment and 415 with Tanreqing injection based on conventional treatment,only one literature was of high-quality. Meta analysis showed that the therapeutic effect of SIRS treated with Tanreqing injection was better than that treated by routine alone,and it reflected mainly in the following： the total clinical efficiency was increased（ OR = 3. 05,95% CI： 1. 46-6. 39,P = 0. 003）,the level of WBC（ WMD = 1. 39,95% CI： 2. 25 to 0. 53,P = 0. 002）,the level of CRP（ WMD = 13. 78,95% CI： 19. 96 to7. 60,P〈0. 00 01）,the level of PCT（ SMD = 2. 17,95% CI： 4. 23 to 0. 11,P = 0. 04）,the level of TNF-α（ SMD =- 1. 50,95% CI： 2. 14 to 0. 85,P〈0. 00 001）,and the level of IL-6（ WMD =- 24. 04,95% CI： 36. 03 to 12. 05,P〈0. 00 01） were decreased,ant the level of T was decreased（ WMD =- 0. 66,95% CI： 0. 85 to 0. 47,P〈0. 00 01）. No serious adverse reactions were reported. Conclusion Tanreqing injection has good effect in treatment of SIRS.