中成药辅助治疗儿童反复呼吸道感染的网状Meta分析

Network Meta-analysis of Chinese patent medicine in adjuvant treatment of children with recurrent respiratory tract infection

目的系统评价中成药辅助治疗儿童反复呼吸道感染的疗效和安全性。方法计算机检索中国知网(CNKI)、万方(Wanfang)、维普(VIP)、中国生物医学文献数据库(CBM)、PubMed、Cochrane Library、Embase等数据库自建库至2022年2月1日所收录的中成药治疗儿童反复呼吸道感染的随机对照试验,采用RevMan 5.4、Stata 14软件分析数据。结果最终纳入36项研究,干预措施涉及6种中成药,分别为玉屏风颗粒/口服液、槐杞黄颗粒、黄芪颗粒、童康片、黄龙止咳颗粒、馥感啉口服液,对照措施采用常规西医治疗。网状Meta分析的结果显示,常规西医治疗联合中成药治疗效果均高于单纯常规西医治疗,在临床有效率方面中成药排名为童康片>黄龙止咳颗粒>槐杞黄颗粒>玉屏风颗粒/口服液>馥感啉口服液>黄芪颗粒;在提升免疫球蛋白A(immunoglobulin A,IgA)水平方面中成药排名为馥感啉口服液>槐杞黄颗粒>玉屏风颗粒/口服液>童康片>黄芪颗粒;在提升IgG水平方面中成药排名为馥感啉口服液>童康片>黄芪颗粒>槐杞黄颗粒>玉屏风颗粒/口服液;在减少复感次数方面中成药排名为馥感啉口服液>玉屏风颗粒/口服液>槐杞黄颗粒>黄芪颗粒。结论在西医常规治疗基础上联合中成药可提高儿童反复呼吸道感染的临床效果,但由于纳入研究数量和质量的限制,结论仍需高质量的研究加以验证。

Objective To systematically evaluate the efficacy and safety of Chinese patent medicine in the adjuvant treatment of children with recurrent respiratory tract infection.Methods Randomized controlled trials of Chinese patent medicines in the treatment of children with recurrent respiratory tract infection included by CNKI,Wanfang,VIP,CBM,PubMed,Cochrane Library,Embase were searched by computer from the inception of the database to February 1,2022.RevMan 5.4 and Stata 14 software were used to analyze the result index data.Results A total of 36 studies were included,and the intervention measures involved six kinds of Chinese patent medicines,including Yupingfeng Granule/Oral Liquid(玉屏风颗粒/口服液),Huaiqihuang Granule(槐杞黄颗粒),Huangqi Granule(黄芪颗粒),Tongkang Tablet(童康片),Huanglong Cough Granule(黄龙止咳颗粒)and Fuganlin Oral Liquid(馥感啉口服液).Conventional Western medicine was used as the control measures.The results of Network Meta-analysis showed that the curative effect of conventional Western medicine combined Chinese patent medicines were higher than that of conventional Western medicine.In terms of clinical efficiency,Chinese patent medicines ranked as:Tongkang Tablet>Huanglong Cough Granule>Huaiqi Huang Granule>Yupingfeng Granule/Oral Liquid>Fuganlin Oral Liquid>Huangqi Granule.In terms of improving the level of immunoglobulin A(IgA),Chinese patent medicines ranked as:Fuganlin Oral Liquid>Huaiqihuang Granule>Yupingfeng Granule/Oral Liquid>Tongkang Tablet>Huangqi Granule.In terms of improving IgG level,Chinese patent medicines ranked as:Fuganlin Oral Liquid>Tongkang Tablets>Huangqi Granules>Huaiqihuang Granules>Yupingfeng Granules/Oral Liquid;In terms of reducing the frequency of relapse,the Chinese patent medicines ranked as:Fuganlin Oral Liquid>Yupingfeng Granule/Oral Liquid>Huaiqi Huang Granule>Huangqi Granule.Conclusion On the basis of Western medicine conventional treatment combined with Chinese patent medicines can improve the clinical effect of children with recurrent respiratory tract infection.However,due to the limitation of the quantity and quality of the included studies,the conclusion still needs to be verified by high-quality studies.