热毒宁注射液与利巴韦林注射液治疗儿童手足口病疗效比较的系统评价

Systematic Review of Efficacy of Reduning Injection and Ribavirin Injection in the Treatment of Children with Hand,Foot and Mouth Disease

目的:系统评价热毒宁注射液与利巴韦林注射液分别治疗儿童手足口病的临床疗效。方法:检索中国知网、万方数据库、维普数据库、PubMed、EMBase及the Cochrane Library等数据库,纳入热毒宁注射液与利巴韦林注射液治疗儿童手足口病疗效比较的随机对照研究(对照组患儿采用利巴韦林注射液治疗,观察组患儿采用热毒宁注射液治疗),检索时限为建库至2019年2月25日。运用Cochrane偏倚风险评估工具评价文献质量,排除含高风险项的文献,将符合纳入标准的文献录入Rev Man 5. 3软件中进行荟萃分析(Meta分析)。结果:最终纳入27篇文献,Meta分析结果显示,观察组患儿的总有效率明显高于对照组(OR=7. 12,95%CI=5. 41~9. 38,P<0. 000 01),体温恢复时间(MD=-1. 34,95%CI=-2. 24^-0. 44,P=0. 003)、疱疹消退时间(MD=-1. 62,95%CI=-1. 89^-1. 34,P<0. 000 01)、咽部红肿消退时间(MD=-2. 32,95%CI=-2. 46^-2. 18,P<0. 000 01)和病程(MD=-1. 75,95%CI=-2. 57^-0. 92,P <0. 000 01)明显短于对照组,不良反应发生率明显低于对照组(OR=0. 27,95%CI=0. 11~0. 67,P=0. 005),上述差异均有统计学意义。结论:热毒宁注射液治疗儿童手足口病,在提高临床总有效率、改善临床症状、缩短病程及用药安全性方面均优于利巴韦林注射液。

OBJECTIVE: To systematically evaluate the clinical efficacy of Reduning injection and ribavirin injection respectively in the treatment of children with hand,foot and mouth disease. METHODS: CNKI,Wanfang database,VIP database,PubMed,EMBase and the Cochrane Library were retrieved to collect the randomized controlled trial of Reduning injection and ribavirin injection respectively in the treatment of children with hand,foot and mouth disease( the control group was treated with ribavirin injection,while the observation group received Reduning injection). The retrieve time was from the establishment of the database to Feb. 25 th,2019. The Cochrane bias risk assessment tool was used to evaluate the quality of the literature,and the literature containing high-risk items was excluded. The literature that met the inclusion criteria was entered into the RevMan 5. 3 software for Meta-analysis.RESULTS: Totally 27 literature were collected. Meta-analysis results showed that the total effective rate of the observation group was significantly higher than that in the control group( OR = 7. 12,95% CI = 5. 41-9. 38,P <0. 000 01),the recovery time of temperature( MD =-1. 34,95% CI =-2. 24--0. 44,P = 0. 003),the disappearance time of herpes( MD =-1. 62,95% CI =-1. 89--1. 34,P < 0. 000 01),the disappearance time of pharyngeal swelling( MD=-2. 32,95%CI=-2. 46--2. 18,P<0. 000 01) and the course of disease( MD=-1. 75,95%CI=-2. 57--0. 92,P<0. 000 01) were significantly shorter than those in the control group,the incidence of adverse drug reactions was significantly lower than that of the control group( OR = 0. 27,95%CI = 0. 11-0. 67,P = 0. 005),the above differences were statistically significant. CONCLUSIONS: Retonin injection is better than ribavirin injection in the treatment of children with hand,foot and mouth disease in improving clinical total effective rate,improving the clinical symptoms,shortening the course of disease and safety of medication.