培土生金方药对比H1抗组胺药治疗变应性鼻炎的系统评价与Meta分析

Systematic review and Meta-analysis of Peitu Shengjin prescription versus H antihistamine in the treatment of allergic rhinitis

目的:评价培土生金方药对比H1抗组胺药治疗变应性鼻炎的疗效与安全性。方法:检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、Embase、The Cochrane Library中所有已发表关于培土生金方药对比H1抗组胺药治疗变应性鼻炎的随机对照试验(RCTs),两名研究员按纳入、排除标准筛选文献,采用RevMan5.3软件进行Meta分析。结果:共纳入22项研究,共涉及研究对象1 463例,其中治疗组822例,对照组641例。Meta分析结果显示:与口服H1抗组胺药相比,培土生金方药治疗变应性鼻炎可提高总有效率[RR=1.19,95%CI(1.14,1.24),P<0.000 01];降低复发率[RR=0.46,95%CI(0.23,0.90),P=0.02];降低血清IL-6[MD=-17.33,95%CI(-21.96,-12.70),P<0.00001]和血清IL-8[MD=-100.35,95%CI(-175.18,-25.52),P=0.009];降低患者症状体征总积分[SMD=-1.21,95%CI(-1.82,-0.61),P<0.000 1]及中医症候积分[SMD=-0.98,95%CI(-1.28,-0.68),P<0.000 01];在改善患者鼻塞、鼻痒、鼻甲/鼻黏膜肿大方面优于对照组,在改善流涕、喷嚏症状方面与对照组相比无明显优势;在安全性方面,治疗组发生轻度不良反应更少[RD=-0.05,95%CI(-0.09,-0.00),P=0.04]。结论:与H1抗组胺药相比,培土生金方药治疗变应性鼻炎可提高临床疗效,改善患者症状体征及中医症候,调节免疫功能,且不易复发,安全性良好。

Objective:To evaluate the efficacy and safety of Peitu Shengjin prescription versus H1 antihistamine in the treatment of allergic rhinitis. Methods:Electronic searching "China Knowledge Network", "Wanfang Database", "Vip Database", "Chinese Biomedical Literature Database",Pub Med,Embase,The Cochrane Library,all published on the prescription of Peitu Shengjin prescription comparison H1 antihistamine In randomized controlled trials(RCTs)of drug treatment of allergic rhinitis,two researchers screened the literature according to the inclusion and exclusion criteria,and conducted Meta-analysis using RevMan5.3 software. Results:A total of 22 studies were involved,involving a total of 1 463 subjects,including 822 in the treatment group and 641 in the control group. Meta-analysis results show that compared with oral H1 antihistamines,Peitu Shengjin prescription can improve the total effective rate of allergic rhinitis(RR=1.19,95%CI[1.14,1.24],P<0.000 01);reduce recurrence Rate(RR=0.46,95% CI[0.23,0.90],P=0.02);reduce serum IL-6(MD=-17.33,95% CI[-21.96,-12.70],P<0.000 01)and serum IL-8(MD=-100.35,95% CI[-175.18,-25.52],P=0.009);reduce the patient’s total score of symptoms and signs(SMD=-1.21,95% CI[-1.82,-0.61],P<0.000 1)And TCM symptom scores(SMD=-0.98,95%CI[-1.28,-0.68],P<0.000 01);superior to the control group in improving patients’ nasal congestion,nasal itching,and turbinate/nasal mucosa enlargement,in improving runny nose There is no obvious advantage compared with the control group in terms of sneezing symptoms;in terms of safety,there are fewer mild adverse reactions in the treatment group(RD=-0.05,95% CI[-0.09,-0.00],P=0.04).Conclusion:Compared with H1 antihistamine,Peitu Shengjin prescription can improve clinical efficacy,improve patients’ symptoms and signs and TCM symptoms,regulate immune function,and is not easy to relapse and has good safety.