穿琥宁注射剂治疗儿童支气管肺炎的系统评价

Potassium Dehydroandrograpolide Succinate Injection for Treatment of Pediatric Bronchopneumonia: A Systematic Review

目的：评价穿琥宁注射剂治疗儿童支气管肺炎的疗效。方法：检索Pub Med、The Cochrane Library、EMbase、中国生物医学文献数据库（CBM）、中国知网（CNKI）、维普数据库（VIP）、万方数据库（Wan Fang data）关于穿琥宁注射剂治疗儿童支气管肺炎的文献,检索时间截止至2016年9月26日。根据纳入与排除标准筛选文献、提取资料和评价文献质量后,采用Revman 5.3软件进行统计分析。结果：共纳入19项随机对照试验,包括2150例患者。Meta分析结果显示：（1）穿琥宁注射剂可改善儿童支气管肺炎患者的总有效率[RR=1.14,95%CI（1.11~1.18）,P〈0.000 01];（2）穿琥宁注射剂可减少儿童支气管肺炎患者的止咳时间[RR=-1.05,95%CI（-1.17^-0.93）,P〈0.000 01];（3）穿琥宁注射剂可减少儿童支气管肺炎患者的退热时间[RR=-1.04,95%CI（-1.15^-0.92）,P〈0.000 01];（4）穿琥宁注射剂可减少儿童支气管肺炎患者的罗音消失时间[RR=-0.96,95%CI为（-1.21^-0.72）,P〈0.000 01];（5）穿琥宁注射剂可减少儿童支气管肺炎患者的平喘时间[RR=-1.79,95%CI（-3.14^-0.45）,P=0.009];（6）穿琥宁注射剂可缩短儿童支气管肺炎患者的住院时间[RR=-1.79,95%CI（-2.82^-0.76）,P=0.000 7）;（7）纳入的穿琥宁注射剂治疗儿童支气管肺炎试验中,试验组共发生皮疹3例,血管刺激1例,腹泻1例。结论：穿琥宁注射剂治疗儿童支气管肺炎时有助于改善患者总有效率、止咳时间、退热时间、罗音消失时间、平喘时间,但也伴随着皮疹、血管刺激、腹泻等不良反应的发生。该药在临床上使用应当进行更大规模的临床试验以提供更高等级的证据。

Objective： To evaluate the curative effect of the potassium dehydroandrograpolide succinate injection for pediatric bronchopneumonia. Method： Searching Pubmed、The Cochrane Library、EMbase、CBM、CNKI、VIP、Wan Fang data for literature about the treatment of the potassium dehydroandrograpolide succinate injection for pediatric bronchopneumonia to September 26 2016. The literature was included and excluded by pre standard,then extracting data and assessing the literature quality. The Revman 5. 3 were used for statistical analysis. Results： There were 19 random controlled trails and 2150 patients were included. The result of Meta analysis：（1）The potassium dehydroandrograpolide succinate injection can improve the total effective rate of pediatric bronchopneumonia[RR = 1. 14,95% CI（ 1. 11 ~ 1. 18）,P 0. 000 01 ];（2）The potassium dehydroandrograpolide succinate injection can decrease the period of cough of pediatric bronchopneumonia[RR =-1. 05,95% CI（-1. 17 ^-0. 93）,P 0. 000 01];（3）The potassium dehydroandrograpolide succinate injection can decrease the duration of fever of pediatric bronchopneumonia[RR =-1. 04,95% CI（-1. 15 ^-0. 92）,P 0. 000 01];（4）The potassium can decrease the in hospital time of pediatric bronchopneumonia[RR =-1. 79,95% CI（-2. 82 ^-0. 76）,P = 0. 000 7];（5）In the included treating trails for the pediatric bronchopneumonia,there were 3 patients with rash,1 patient with vascular stimulation and 1 patient with diarrhea in experimental group. Conclusions： The potassium dehydroandrograpolide succinate injection can improve the total rate of effect and decrease the period of cough、fever、vale、wheezing and in hospital time,but accompanying with some adverse drug reaction such as rash、vascular stimulation and diarrhea. The large-scale trail should be conducted for potassium dehydroandrograpolide succinate injectionto supply the higher level evidence.