喜炎平与炎琥宁治疗小儿急性支气管炎临床疗效和安全性对比的系统评价

Comparison of efficacy and safety of Yanhuning and Xiyanping in the treatment of acute bronchitis in children:a meta-analysis

目的:采用系统评价比较喜炎平与炎琥宁治疗小儿急性支气管炎的有效性及安全性。方法:2名作者分别独立进行文献筛选、检索Pubmed、Embase、The Cochrane library、知网、万方、维普等数据库,收集喜炎平与炎琥宁治疗小儿急性支气管炎的RCTs和病例对照研究并进行质量评价、数据提取和风险偏移分析,根据Cochrane系统评价的原理和方法,使用Cochrane协作网提供的RevMan 5.3软件进行Meta分析。结果:纳入15项研究,均为病例对照研究,共计2026例患儿进行meta分析,其中喜炎平治疗组1029例,炎琥宁治疗组997例;结果显示,与炎琥宁相比,喜炎平治疗小儿急性支气管炎在总有效率显著提高(OR=3.09,95%CI 1.65,5.82,P<0.001),咳嗽消失时间明显缩短(MD=-1.40,95%CI-1.88,-0.93,P<0.001),肺部啰音消失时间明显缩短(MD=-1.72,95%CI-1.99,-1.45,P<0.001),发热消退时间明显缩短(MD=-0.68,95%CI-0.99,-0.37,P<0.001),不良反应发生率显著降低(OR=0.31,95%CI 0.20,0.47,P<0.001)。结论:与炎琥宁相比,喜炎平能显著提高急性支气管炎患儿治疗的总有效率,明显降低患儿发热、咳嗽以及肺部啰音等临床症状时间和不良反应发生率。

Objective:To compare the efficacy and safety of Yanhuning and Xiyanping in the treatment of acute bronchitis in children by a meta-analysis.Methods:Two researchers independently conducted searches in databas⁃es including PubMed,EMBASE,The Cochrane Library,CNKI,WanFang Data,VIP for randomized controlled tri⁃als and case-control studies of Xiyanping and Yanhuning in the treatment of acute bronchitis in children.Quality evaluation,data extraction,and risk drift analysis were performed on the enrolled articles.According to the princi⁃ple and method of Cochrane system evaluation,the enrolled articles were analyzed using RevMan 5.3 software pro⁃vided by Cochrane Collaboration Network.Results:A total of 15 case-control studies involving 2026 patients were included for meta-analysis.In these patients,1029 were in the group Xiyanping and 997 in the group Yanhuning.Compared with Yanhuning,Xiyanping significantly improved the overall response rate(odds ratio[OR]=3.09,95%confidence interval[CI]:1.65-5.82,P<0.001),and significantly shortened the cough disappearance time(mean difference[MD]=-1.40,95%CI:-1.88 to-0.93,P<0.001),disappearance time of pulmonary rales(MD=-1.72,95%CI:-1.99 to-1.45,P<0.001),and fever regression time(MD=-0.68,95%CI:-0.99 to-0.37,P<0.001).Xiyanping also significantly reduced the incidence of adverse reactions(OR=0.31,95%CI:0.20-0.47,P<0.001).Conclusion:Compared with Yanhuning,Xiyanping significantly improves the overall re⁃sponse rate and reduces the duration of clinical symptoms such as fever,cough,and pulmonary rales and the inci⁃dence of adverse reactions in children with acute bronchitis.