复方中药治疗儿童抽动障碍随机对照试验的Meta分析

A Meta-analysis of randomized controlled trials of compound Chinese medicine in the treatment of children with Tic disorders

目的评价复方中药治疗儿童抽动障碍的疗效和安全性。方法计算机检索PubMed、CNKI、万方、维普等中英文数据库从2015年1月1日至2019年3月31日复方中药治疗儿童抽动障碍的随机对照试验文献,由两位研究员进行文献筛选,应用RevMan5.3软件中ROB偏倚风险评估表对纳入文献的质量进行评估并进行Meta分析。结果最终共有29篇文献,2370例患儿纳入了本项研究。本次Meta分析结果显示,复方中药治疗儿童抽动障碍的总有效率高于西药组[OR=2.23,95%CI(1.73,2.87),P<0.00001],复方中药组的远期疗效(半年)高于西药组[OR=4.92,95%CI(3.16,7.66),P<0.00001],耶鲁评分方面两组比较差异无统计学意义,其中有20篇文献报告了不良反应。结论根据近四年半随机对照试验文献显示,复方中药在治疗抽动障碍方面有良好的临床效果,但因纳入研究的文献质量较低且存在发表偏倚等可能性,想要获得更加可靠、准确的评价,仍需要大样本、多中心的高质量随机对照试验研究以提供临床依据。

Objective To evaluate the efficacy and safety of compound Chinese medicine in the treatment of children with Tic disorders.Methods Randomized controlled trials of compound Chinese medicine in the treatment of children with Tic disorders from January 1,2015 to March 31,2019 were retrieved from PubMed,CNKI,Wanfang and Weipu databases by computer;two researchers screened the papers;ROB bias risk assessment form in RevMan 5.3 software was used to evaluate the quality of included papers and Meta-analysis was performed.Results A total of 29 papers containing 2 370 cases were included in the study.The Meta-analysis showed that the total effective rate of TCM group was higher than that of western medicine group in the treatment of children with Tic disorders[OR=2.23,95%CI(1.73,2.87),P<0.000 01]and the long-term(half a year)efficacy of TCM group was higher than that of western medicine group[OR=4.92,95%CI(3.16,7.66),P<0.000 01],but there was no significant difference in Yale score between the two groups;twenty of them reported side effects.Conclusion According to the studies of randomized controlled trials in the recent four and a half years,compound Chinese medicines have good clinical effects in the treatment of Tic disorders.However,due to the low quality of the papers included in the study and the possibility of publication bias,large sample,multi-center,high-quality randomized controlled trials are still needed to provide clinical basis in order to obtain more reliable and accurate evaluation.