中医药治疗小儿热型哮喘疗效评价的Meta分析

Traditional Chinese Medicine for Infantile Heat Asthma: A Meta-analysis

目的:系统评价中医药治疗小儿热型哮喘的临床疗效及安全性。方法:计算机检索Pub Med、CBM、CNKI、VIP和Wan Fang Data等数据库,查找相关随机对照试验,检索时限均从1995年1月1日—2015年10月31日。由2位研究者独立进行文献筛选、数据提取及对纳入文献质量评价后,采用Rev Man 5.3软件进行Meta分析。结果:共纳入17个RCT,在哮鸣音消失时间方面及总体疗效方面,均显示中药疗效优于单纯西药治疗;而对于改善气道高反应性,治疗后PEF的变化情况治疗组优于对照组,而FEV1两组无显著性差异。17个纳入研究均未报告与中药相关的不良反应。结论:基于当前临床证据,结果显示中药在哮鸣音消失时间及总体疗效方面与单纯西药比较有一定优势,而对于改善气道高反应性方面与单纯西药比较有部分优势,尚需进一步研究。因本研究纳入文献所涉药物种类繁多,且受纳入研究方法学质量以及干预手段不一致等限制,以上初步结论尚需开展更多高质量大样本的RCT从而进一步明确。

Objective： To systematically review the clinical effect and safety of traditional Chinese medicine（ TCM） in the treatment of infantile heat asthma. Methods： We searched Pub Med,CBM,CNKI,VIP and Wan Fang Data databases to collect randomized controlled trials（ RCTs） about TCM for infantile heat asthma from January 1,1995 to October 31,2015. Two reviewers independently screened the literature,extracted the data and assessed the risk of bias of included studies. And then the Meta-analysis was performed by Rev Man 5. 3 software. Results： A total of 17 RCTs were included.The results showed that wheezing sound disappearing time and overall treatment effect in all RCTs showed that TCM was superior to western medicine alone. In improving airway hyper responsiveness,after treatment,the change of PEF treatment group was better than the control group and FEV1 in two groups had no significant difference. No serious adverse reactions related to TCM was reported in 17 RCTs. Conclusion： Based on the current evidence,some trials suggested the TCM was superior to western medicine alone in wheezing sound disappearing time and overall efficacy,however in the improvement of airway hyperresponsiveness,the TCM has some advantages and still needs deep study. Due to the variety of TCM and western medicine as well as limited methodological quality and different intervention of the included studies,more high-quality RCTs with large scale are needed to verify the above conclusion.