复方甘草酸苷联合西咪替丁治疗儿童过敏性紫癜的有效性与安全性的系统评价

Systematic Review on Efficacy and Safety of Compound Glycyrrhizin Combined with Cimetidine in the Treatment of Henoch-Schonlein Purpura in Children

目的:系统评价复方甘草酸苷联合西咪替丁治疗儿童过敏性紫癜的有效性和安全性。方法:计算机检索PubMed、Medline、EMBase、万方数据库和中国知网等电子数据库,纳入复方甘草酸苷联合西咪替丁治疗儿童过敏性紫癜的随机对照试验或半随机对照试验(研究组患儿采用复方甘草酸苷联合西咪替丁治疗,对照组患儿采用复方甘草酸苷或西咪替丁单一治疗),检索时间为从建库至2019年12月,对符合纳入标准的研究进行质量评价,使用RevMan 5.3软件进行荟萃分析(Meta分析)。结果:纳入18篇文献,共1613例患儿。Meta分析结果显示,与复方甘草酸苷或西咪替丁单一治疗比较,复方甘草酸苷联合西咪替丁治疗儿童过敏性紫癜可以显著提高患儿的临床总有效率(OR=5.58,95%CI=3.88~8.03,P<0.00001),并明显缩短紫癜症状消失时间(MD=-3.87,95%CI=-4.26~-3.48,P<0.00001)、消化道症状消失时间(MD=-2.97,95%CI=-3.53~-2.41,P<0.00001)和住院时间(MD=-4.70,95%CI=-7.29~-2.12,P=0.0004),上述差异均有统计学意义;且两组治疗方案不良反应发生率的差异无统计学意义(OR=1.03,95%CI=0.60~1.77,P=0.92)。结论:复方甘草酸苷联合西咪替丁治疗儿童过敏性紫癜的临床疗效较好,可明显缩短紫癜症状消失时间、消化道症状消失时间及住院时间,且安全性较好。受纳入研究质量所限,上述结论仍需更多高质量、大样本随机对照试验加以验证。

OBJECTIVE:To systematically review the effect and safety of compound glycyrrhizin combined with cimetidine in the treatment of henoch-schonlein purpura in children.METHODS:Randomized controlled trails or semi-randomized controlled trials on compound glycyrrhizin and cimetidine in the treatment of henoch-schonlein purpura in children(the research group was given compound glycyrrhizin and cimetidine,while the control group was given compound glycyrrhizin or cimetidine alone)were retrieved from PubMed,Medline,EMBase,Wanfang database and CNKI from base-building to Dec.2019,quality evaluation was conducted on those studies met the inclusion criteria,and RevMan 5.3 was adopted to conduct Meta-analysis.RESULTS:Totally 18 studies were involved,including 1613 children.Results of Meta-analysis indicated that compared with compound glycyrrhizin or cimetidine alone,the combination of compound glycyrrhizin and cimetidine in the treatment of henoch-schonlein purpura in children can significantly improve the clinical effective rate(OR=5.58,95%CI=3.88-8.03,P<0.00001),and significantly shorten the disappearance time of purpura symptom(MD=-3.87,95%CI=-4.26--3.48,P<0.00001),disappearance time of digestive symptom(MD=-2.97,95%CI=-3.53--2.41,P<0.00001)and length of hospital stay(MD=-4.70,95%CI=-7.29--2.12,P=0.0004),with statistically significant differences;there was no statistical significance in the difference in incidences of adverse drug reactions between two therapeutic regimens(OR=1.03,95%CI=0.60-1.77,P=0.92).CONCLUSIONS:The clinical efficacy of compound glycyrrhizin combined with cimetidine in the treatment of henoch-schonlein purpura in children is remarkable,which can significantly shorten the disappearance time of purpura symptom,disappearance time of digestive symptom and length of hospital stay,with good safety.Due to the quality of the involved studies,the above conclusions still need to be validated by additional high-quality,large-sample randomized controlled trials.