清热解毒类中药口服液治疗手足口病的网状Meta分析

A network meta analysis of Qingre Jiedu traditional Chinese medicine oral liquid in the treatment of hand foot mouth disease

目的:运用网状Meta分析评价7种中药口服液治疗手足口病的临床疗效与安全性。方法:全面检索从建库至2019年1月的CNKI、VIP、WanFang Data、CBM、The Cochrane Library、PubMed、EMbase、Web of Science数据库,筛选出符合纳入标准的随机对照研究,采用RevMan5.3对纳入研究进行方法学质量评价,R软件进行网状Meta数据结果合并比较与排序。结果:临床有效率方面,7种中药口服液均能有效提高临床疗效,以蒲地蓝口服液治疗效果最显著;手足皮疹消退、口腔溃疡痊愈与退热皆以抗病毒口服液所用时间最短;不良反应方面以蒲地蓝口服液临床安全性最高。结论:7种中药口服液均能有效治疗手足口病,在临床疗效与相关症状痊愈时间方面,中药口服液具有较好的治疗效果。尽管本研究得出蒲地蓝口服液为临床首选用药,但明确的结论仍需要更多高质量随机对照文献来进一步证实,临床可根据病人的具体特征进行准确选择应用。

Objective:To evaluate the clinical efficacy and safety of seven kinds of oral liquid of Chinese medicines in the treatment of Hand-foot-mouth Disease(HFMD)by the network meta-analysis(NMA).Methods:We searched the CNKI,VIP,WanFang Data,CBM,the Cochrane Library,PubMed,Embase and Web of science from inception to January 2019,to collect randomized controlled trials(RCTs)which met our included standards.The methodological quality of included studies were assessed by RevMan5.3,R software was used for statistical analysis.Results:All the seven kinds of oral liquid of traditional Chinese medicine can improve the clinical efficacy.Pudilan oral liquid had the most significant effect.Antiviral oral liquid was the most effective treatment in shorting the time of hand foot rash regression,oral ulcer recovery and fever abatemen.In the adverse reactions aspect,Pudilan oral liquid had the highest clinical safety.Conclusion:All the seven Traditional Chinese medicine oral liquids had good therapeutic effects in clinical efficacy and recovery time of related symptoms.Although this study showed that Pudilan oral liquid may be the best medicine for HFMD,this conclusion is still immaturity and needs to further verified by high-quality RCTs study.It is better to consider clinical situation and syndrome differentiation in clinical application.