痰热清注射液治疗老年慢性支气管炎临床效果及安全性的Meta分析

Meta-analysis on Clinical Effect and Safety of Tanreqing Injection in Treatment of Elderly Chronic Bronchitis

目的:系统评价痰热清注射液治疗老年慢性支气管炎的临床疗效。方法:计算机检索CBM,CNKI,WanFang Data,VIP,PubMed,The Cochrane Library,Embase等数据库,遴选痰热清注射液治疗老年慢性支气管炎的随机对照试验,检索时间限定为从建库至2019年12月。由两位录入员按纳入与排除标准独立筛选文献、提取资料并进行文献质量评价后,采用RevMan 5.3软件进行Meta分析,采用Stata 14.0软件进行Egger检验以评估发表偏倚,若存在发表偏倚则进一步运用剪补法评估偏倚对结果的影响。结果:共纳入48个研究,包括4 356例老年慢性支气管炎患者。Meta分析结果显示,与常规抗生素治疗相比,联合痰热清注射液组在有效率、降低血清C反应蛋白(CRP)水平等方面均优于对照组,差异均有统计学意义。发表偏倚检验结果显示有效率存在发展偏倚,运用非参数剪补法进一步分析结果提示Meta分析结果较稳定,可能存在的发表偏倚未对结果造成影响。不良反应的发生不具有统计学意义。结论:该研究表明痰热清注射液治疗老年慢性支气管炎疗效显著,可以降低患者血清CRP水平,且与常规治疗组相比,不良反应发生率没有明显增加,结果尚有待临床进一步检验。

Objective: To systematically evaluate the clinical efficacy of Tanreqing injection in the treatment of elderly chronic bronchitis. Method: CBM,CNKI,WanFang Data,VIP,PubMed,The Cochrane Library,Embase and other databases were retrieved by computer to screen out randomized controlled trials of Tanreqing injection in the treatment of elderly chronic bronchitis. The retrieval time was from the establishment to December 2019. After two researchers independently screened out the literatures according to the inclusion and exclusion criteria,extracted data and evaluated the literature quality,made meta-analysis using RevMan 5.3 software,and performed Egger test by Stata 14.0 software to evaluate publication bias. In case of any publication bias,clipping and supplementation method was further used to evaluate the effect of bias on the results. Result:A total of 48 studies were included,including 4 356 patients with diabetic nephropathy. The results of Metaanalysis showed that compared with conventional antibiotic therapy,the group of combination with Tanreqing injection was better than the control group in effective rate and lowering serum c-reactive protein(CRP)level,with statistically significant differences. The results of the publication bias test showed that a developmental bias in the effective rate. Further analysis based on the non-parametric clipping and supplementation method showed stable results of meta-analysis and no impact from potential publication bias. The adverse reactions had no statistically significance. Conclusion: This study shows that Tanreqing injection has a significant effect in treating chronic bronchitis in the elderly,and can reduce the serum CRP level of the patients. Compared with the conventional therapy group,the incidence of adverse reactions is not significantly increased,and the results need further clinical tests.