痰热清注射液联合头孢呋辛钠治疗小儿支气管肺炎疗效的系统评价

Clinical Efficacy and Safety of Tanreqing Injection Combined with Cefuroxime Against Bronchial Pneumonia in Children:a Systematic Review

目的:系统评价痰热清注射液联合头孢呋辛钠治疗小儿支气管肺炎的有效性及安全性。方法:检索中国生物医学文献服务系统(CBM)、中国期刊全文数据库(CJFD)、中国学术期刊数据库(CSPD)、中文科技期刊数据库(CCD)、Cochrane Library、PubMed、Embase等数据库,查找干预措施为痰热清注射液联合头孢呋辛钠治疗小儿支气管肺炎的随机对照试验,并按照纳入与排除标准筛选文献、提取资料,采用Cochrane Handbook5.3版偏倚风险评估工具予以方法学质量评价,采用RevMan5.3软件进行统计分析。结果:纳入12篇文献共计患者1258例;Meta分析结果显示,痰热清注射液联合头孢呋辛钠组在总有效率(RR=1.21,95%CI为1.16~1.26,P<0.00001);咳嗽消失时间(MD=-1.51,95%CI为-1.89~-1.13,P<0.00001);退热时间(MD=-1.93,95%CI为-2.20~-1.65,P<0.00001);肺部啰音消失时间(MD=-1.56,95%CI为-1.86~-1.27,P<0.00001);肺部浸润影消失时间(MD=-2.97,95%CI为-4.85~-1.08,P=0.002);住院时间(MD=-1.45,95%CI为-1.73~-1.18,P<0.00001)等方面均优于单用头孢呋辛钠组;12项研究不良反应轻微,无严重不良反应。结论:痰热清注射液联用头孢呋辛钠治疗小儿支气管肺炎疗效优于单纯使用头孢呋辛钠,且相对安全。但由于纳入的研究质量普遍较低,还需设计多中心大样本随机双盲对照试验提供更有说服力的证据。

Objective:To systematically evaluate the efficacy and safety of TanReqing Injection combined with cefuroxime in the treatment of bronchopneumonia in children.Methods:SinoMed,CNKI,VIP,Wanfang,Cochrane Library,PubMed and Embase and other databases were retrieved.We found the intervention measures for the randomized controlled trial of Tanreqing Injection combined with cefuroxime sodium in the treatment of bronchial pneumonia in children,and selected the literature and extract data according to the inclusion and exclusion criteria,and used the Cochrane Handbook version 5.3 bias risk assessment tool to evaluate the methodological quality.RevMan5.3 software was used for statistical analysis.Results:A total of 12 literature were adopted including 1258 patients.Meta analysis showed that Tanreqing combined with cefuroxime group had total effective rate[RR=1.21,95%CI(1.16 to 1.26),P<0.00001];cough disappearance time[MD=-1.51,95%CI(-1.89,-1.13),P<0.00001];fever withdrawal time[MD=-1.93,95%CI(-2.20,-1.65),P<0.00001];Time of disappearance of lung rales[MD=-1.56,95%CI(-1.86 to-1.27),P<0.00001];the disappearance time of lung infiltrates(MD=-2.97,95%CI was-4.85~-1.08,P=0.002);hospitalization time[MD=-1.45,95%CI(-1.73 to-1.18),P<0.00001]were better than the cefuroxime group;12 studies had mild adverse reactions and with no serious adverse reactions.Conclusion:Tanreqing injection combined with cefuroxime in the treatment of bronchopneumonia in children is better than cefuroxime alone,and relatively safe.However,due to the generally low quality of the included studies,it is necessary to design more multi-center,large-sample,randomized,double-blind controlled trials to provide more convincing evidence.