小青龙汤治疗小儿咳嗽变异性哮喘有效性与安全性的系统评价

A meta-analysis of Xiaoqinglong decoction on treatment of pediatric patients with coughing variant asthma

目的:系统评价小青龙汤治疗小儿咳嗽变异性哮喘的有效性与安全性。方法:计算机检索The Cochrane Library、Pub Med、Web of Science、中国生物文献数据库(CBM)、万方数据库、中文科技期刊数据库(维普)数据库(VIP)、中国知网(CNKI),查找关于小青龙汤治疗小儿咳嗽变异性哮喘的随机对照试验,检索时限均从建库至2015年10月25日。由两名研究者按照纳入与排除标准独立筛选文献、提取资料并评价质量后,采用Rev Man 5.3软件进行Meta分析。结果:共纳入6个研究,共计560例患者。Meta分析结果显示:小青龙汤治疗咳嗽变异性哮喘总有效率优于传统治疗[RR=1.23,95%CI(1.14,1.33)P<0.01];亚组分析显示小青龙汤与西药联合治疗总有效率优于小青龙汤单独治疗效果[[RR=1.26,95%CI(1.14,1.40),P=0.01],[RR=1.20,95%CI(1.08,1.34),P<0.01]];疗程比较发现疗程14天和28天在治疗咳嗽变异性哮喘的疗效差异不大;小青龙汤能降低不良反应发生率和复发率[RR=0.23,95%CI(0.05,0.92),P=0.04]。结论:小青龙汤治疗小儿咳嗽变异性哮喘方面在有效率与降低不良反应方面优于传统西药治疗,但上述结论尚需开展更多研究予以验证。

Objective: To systematically review the clinical efficacy and security of Xiaoqinglong Decoction in pediatric patients with coughing variant asthma. Methods: Databases such as The Cochrane Library, Pub Med, Embase, Web of Science, CBM, Wan fang Data, VIP and CNKI were searched for the studies about Xiaoqinglong Decoction as interventions for the treatment of coughing variant asthma from inception to October 25 th,2015.Two reviewers independently screened literature, extracted data and evaluated methodological quality. Then metaanalysis was conducted using Rev Man 5.3 software. Results: A total of 6 studies involving 560 patients were included. The results of metaanalysis showed that, compared traditional treatments,Xiaoqinglong Decoction significantly improve the cure rate(RR=1.23,95% CI(1.14,1.33)P<0.011),subgroup analysis showed that compared with Xiaoqinglong Decoction separately, Xiaoqinglong Decoction combined with western medicine significantly increased the effective rate((RR=1.26,95%CI(1.14,1.40),P=0.01),(RR=1.20,95%CI(1.08,1.34),P<0.01)), 14-day and28-day found no significant differences in effectiveness of clinical symptoms treatment, Xiaoqinglong Decoction reduce the incidence of adverse reactions and recurrence rate(RR=0.23,95%CI(0.05,0.92),P=0.04). Conclusion: Xiaoqinglong Decoction has a better curative effect on improving the cure rate and reducing adverse reaction than western medicine, due to deficiencies existing in this research, the results need high quality of randomized controlled trials to test and verify.