基于网状Meta分析探讨10种中成药辅助治疗儿童肺炎支原体肺炎的临床疗效

Exploration of the clinical efficacy of 10 kinds of Chinese patent medicines in adjuvant treatment of Mycoplasma pneumoniae pneumonia in children

目的通过网状Meta分析系统评价10种中成药辅助治疗儿童肺炎支原体肺炎(MPP)的疗效。方法计算机检索CNKI、VIP、CBM、Wan Fang Date、PubMed、Cochrane Library数据库,检索时间为建库至2020年9月,搜集关于中成药联合阿奇霉素治疗MPP患儿效果的临床试验的文献,由2名评价员独立筛选文献、提取数据及评价文献质量,以临床有效率作为结局指标,采用Revman 5.4、Stata 14.0软件进行网状Meta分析。结果纳入文献48篇,共计4895例MPP患儿,包括10种中成药,网状Meta分析显示:黄连颗粒/口服液、小儿豉翘清热颗粒、小儿肺咳颗粒、小儿肺热咳喘口服液、小儿消积止咳口服液、柴桂退热颗粒、金振口服液、麻甘颗粒、蒲地蓝消炎口服液联合阿奇霉素治疗儿童MPP的临床有效率优于单独使用阿奇霉素,其余药物两两比较差异无统计学意义;根据不同口服中成药累计排序曲线下面积(SUCRA)值的排序结果显示,在提高临床有效率方面,排在前4位的是:小儿肺咳颗粒、小儿消积止咳口服液、柴桂退热颗粒、小儿豉翘清热颗粒。结论中成药辅助阿奇霉素治疗小儿MPP可提高临床有效率,且小儿肺咳颗粒、小儿消积止咳口服液、柴桂退热颗粒与小儿豉翘清热颗粒的效果较其他中成药更优。

Objective To evaluate the efficacy of 10 Chinese patent medicines in adjuvant treatment of Mycoplasma pneumoniae pneumonia(MPP)in children through a network meta-analysis system.Methods Search the CNKI,VIP,CBM,Wan Fang Date,Pubmed,Cochrane Library databases,the search time being from the establishment of the database to September 2020;the literatures on clinical trials of Chinese patent medicine combined with azithromycin in the treatment of children with MPP was collected.Two reviewers screened the literatures,extracted data,and evaluated the quality of the literatures independently.The clinical effectiveness was used as the outcome index.Revman 5.4 and Stata 14.0 softwares were used to conduct network meta-analysis.Results A total of 48 literatures involving 4895 children with MPP were included,concerning 10 Chinese patent medicines.The network meta-analysis showed:The clinical effectiveness of the combination of Huanglian Granules/Oral Liquid,Xiao′er Chiqiao Qingre Granules,Xiaoer Feike Granules,Xiaoer Feire Kechuan Oral Liquid,Xiaoer Xiaoji Zhike Oral Liquid,Chaigui Tuire Granules,Jinzhen Oral Liquid,Magan Granules and Podilan Antipyretic Oral Liquid with azithromycin in the treatment of children′s MPP was better than that of azithromycin alone.The other drugs showed no statistical difference when compared between each two.According to the ranking results of the surace under cumulative ranking area(SUCRA)value of different oral Chinese patent medicines,the top 4 medicines in terms of improving clinical efficiency were:Xiaoer Feike Granules,Xiaoer Xiaoji Zhike Oral Liquid,Chaigui Antipyretic Granules and Xiao′er Chiqiao Qingre Granules.Conclusion Chinese patent medicine assisting azithromycin in the treatment of children with MPP can improve the clinical effectiveness,and the effects of Xiaoer Feike Granules,Xiaoer Xiaoji Zhike Oral Liquid,Chaigui Antipyretic Granules and Xiao′er Chiqiao Qingre Granules are better than other Chinese patent medicines.