中药擦浴对发热成人患者的降温效果及安全性的Meta分析

Meta-analysis of Antipyretic Effectiveness and Safety of Chinese Medicine Sponging Bath During the Treatment of Adult Fever

检索国内外主要期刊数据库中有关中药擦浴降温治疗成人发热患者(试验组)对比常规物理降温方法治疗成人发热患者(对照组)的临床随机对照试验,采用Cochrane手册中的偏倚风险评估工具评价其文献质量,采用RevMan 5.3统计软件进行Meta分析,以评价中药擦浴降温效应的临床疗效及安全性。结果共纳入8篇临床随机对照试验,涉及患者606例。Meta分析结果显示,除治疗后30 min体温2组比较差异无统计学意义(MD=0.20,95%CI[-0.07,0.48],P=0.14)外,2组治疗后1 h体温(MD=-0.25,95%Cl[-0.43,-0.06],P=0.009)、治疗后1.5 h体温(MD=-0.70,95%Cl[-1.06,-0.34],P=0.001)、治疗后2 h体温(MD=-0.85,95%Cl[-0.97,-0.73],P<0.00001)、治疗后2.5 h体温(MD=-0.96,95%Cl[-1.65,-0.26],P=0.007)及总不良反应发生率(OR=0.30,95%Cl[0.18,0.52],P<0.0001)比较,差异均具有统计学意义(P<0.01)。根据分析结果可初步认为,中药擦浴降温比常规物理降温法具有更持久的疗效及更好的安全性,但因纳入的文献数量有限且部分文献质量较低,结论需高质量临床证据的进一步验证。

The clinical randomized controlled trials of Chinese medicine sponging bath(trial group)vs conventional physical cooling method(control group)for the treatment of adult fever in the main domestic and oversea databases were reviewed.Tools for analysis of bias recommended by Cochrane Reviewer’s Handbook were used for the evaluation of the quality of the literatures,and Revman 5.3 was adopted for the Meta-analysis.And then the clinical antipyretic effectiveness and safety of Chinese medicine sponging bath for the treatment of adult fever were systematically reviewed.The results showed that a total of 8 randomized controlled trials were included,and involved 606 cases.The results of Meta-analysis showed that except that the difference of 30-min body temperature between the trial group and the control group was insignificant(MD=0.20,95%CI[-0.07,0.48],P=0.14),there were statistically significant differences in the one-hour body temperature(MD=-0.25,95%Cl[-0.43,-0.06],P=0.009)the 1.5-hour body temperature(MD=-0.70,95%CI[-1.06,-0.34],P=0.001),the 2-hour body temperature(MD=-0.85,95%CI[-0.97,-0.73],P<0.00001),the 2.5-hour body temperature(MD=-0.96,95%CI[-1.65,-0.26],P=0.007)and the overall incidence of adverse reaction(OR=0.30,95%CI[0.18,0.52],P<0.0001)after treatment between the trial group and the control group.The analysis results preliminarily indicated that the Chinese medicine sponging bath exerts lasting efficacy and high safety than conventional physical cooling method for the treatment of adult fever.But for the small sample size and low quality of the included literature,the conclusion needs to be further verified by high-quality clinical evidence.