蓝芩口服液治疗儿童疱疹性咽峡炎有效性与安全性的Meta分析

Efficacy and Safety of Lanqin Oral Liquid for Herpangina in Children:a Meta-analysis

目的:系统评价蓝芩口服液治疗儿童疱疹性咽峡炎的疗效和安全性。方法:计算机检索PubMed、Embase、中国生物医学文献数据库、中国知网、万方数据库、维普数据库等,收集蓝芩口服液或常规对症治疗联合蓝芩口服液(试验组)对比常规对症治疗(对照组)用于儿童疱疹性咽峡炎的随机对照试验(RCT)。筛选文献、提取资料后按Cochrane系统评价员手册5.1.0评价纳入文献的质量,采用Rev Man 5.3软件进行Meta分析。结果:共纳入11篇RCT,共计1 204例患者。Meta分析结果显示,试验组患儿总有效率显著高于对照组[RR=1.17,95%CI(1.10,1.24),P<0.000 01]、疱疹消退时间[MD=-2.17,95%CI(-2.63,-1.72),P<0.000 01]、发热消退时间[MD=-1.52,95%CI(-1.72,-1.31),P<0.000 01]均显著短于对照组;两组患儿不良反应发生率比较差异无统计学意义[RR=1.00,95%CI(0.52,1.93),P=1.00]。按是否给予补液对症处理进行的亚组分析显示,未给予补液对症处理,试验组患儿疱疹消退时间显著短于对照组[MD=-1.64,95%CI(-2.03,-1.26),P<0.000 01];给予补液对症处理,试验组患儿疱疹消退时间显著短于对照组[MD=-2.79,95%CI(-2.97,-2.61),P<0.000 01]。结论:蓝芩口服液可显著提高疱疹性咽峡炎患儿的疗效,有效缩短疱疹消退时间和发热消退时间,且未增加不良反应的发生。

OBJECTIVE:To systematically evaluate the efficacy and safety of Lanqin oral liquid in the treatment of herpangina in children.METHODS:Randomized controlled trials(RCTs)involving Lanqin oral liquid or routine symptomatic treatment combined with Lanqin oral liquid(trial group)versus routine treatment(control group)in the treatment of pediatric herpangina were retrieved from PubMed,Embase,CBM,CNKI,Wanfang database,VIP database,etc.Meta-analysis was performed by using Rev Man 5.3 software after literature screening,data extraction and quality evaluation with Cochrane system evaluator manual 5.1.0.RESULTS:A total of 11 RCTs were included,involving 1 204 patients.Meta-analysis showed that total response rate[RR=1.17,95%CI(1.10,1.24),P<0.000 01],fade time of herpes[MD=-2.17,95%CI(-2.63,-1.72),P<0.000 01]and fade time of fever[MD=-1.52,95%CI(-1.72,-1.31),P<0.000 01]in trial group was significantly higher than in control group.There was no statistical significance in the incidence of ADR between 2 groups[RR=1.00,95%CI(0.52,1.93),P=1.00].Subgroup analysis based on rehydration symptomatic treatment showed that without rehydration,fade time of herpes in trial group was significantly shorter than control group[MD=-1.64,95%CI(-2.03,-1.26),P<0.000 01];with rehydration,fade time of herpes in trial group was significantly shorter than control group[MD=-2.79,95%CI(-2.97,-2.61),P<0.000 01].CONCLUSIONS:Lanqin oral liquid can effectively improve therapeutic efficacy of herpangina patients,effectively shorten fade time of fever and herpes,without increasing the occurrence of ADR.