6种扶正类中成药治疗儿童咳嗽变异性哮喘的网状Meta分析

A network Meta-analysis of 6 kinds of Chinese patent medicines for strengthening body resistance in the treatment of cough variant asthma in children

目的:采用网状Meta分析评价6种扶正类中成药治疗儿童咳嗽变异性哮喘的临床疗效。方法:计算机检索PubMed、Web of science、中国期刊全文数据库、万方数据库、维普中文期刊服务平台中扶正类中成药治疗儿童咳嗽变异性哮喘的随机对照试验,检索时限为建库至2021年12月10日。采用Cochrane偏倚风险评估工具对纳入文献进行筛选和质量评价,运用Rev Man 5.4和Stata16.0进行数据分析。结果:纳入文献31篇,涉及10种干预措施,共计2 805例患者,其中观察组1 377例,对照组1 428例。网状Meta分析结果显示,在总有效率方面,常规西药联合玉屏风颗粒的疗效最显著,最佳概率排序依次为:常规西药+玉屏风颗粒>常规西药+百令胶囊>常规西药+黄芪颗粒>常规西药+槐杞黄颗粒>常规西药+童康片>黄龙止咳颗粒>玉屏风颗粒>常规西药>黄芪颗粒>槐杞黄颗粒;在复发率方面,常规西药联合槐杞黄颗粒治疗后复发率最低,最佳概率排序依次为:常规西药+槐杞黄颗粒>常规西药+玉屏风颗粒>常规西药+童康片>常规西药>玉屏风颗粒;在改善第1秒用力呼气容积中,最佳概率排序依次为:常规西药+槐杞黄颗粒>常规西药+玉屏风颗粒>常规西药+黄芪颗粒>常规西药+百令胶囊>黄龙止咳颗粒>常规西药。结论:与常规西药或单一中成药相比,中成药联合西药治疗儿童咳嗽变异性哮喘疗效更好。其中,常规西药联合玉屏风颗粒治疗总有效率最高,常规西药联合槐杞黄颗粒治疗后复发率最低,且在改善第1秒用力呼气容积方面效果最显著。

Objective:To evaluate the clinical efficacy of six kinds of Chinese patent medicines for strengthening body resistance in the treatment of cough variant asthma in children by the network Meta-analysis method.Methods:The randomized controlled trials of treating cough variant asthma(CVA)in children with Chinese patent medicines for strengthening body from database initial stage to December 10,2021 were retrieved in databases such as Pub Med,Web of science,CNKI,Wanfang and VIP.Quality of the literature was assessed by the risk of bias tool in the Cochrane Handbook,and Rev Man 5.4 and Stata 16 software were used for a data analysis.Results:Finally,a total of 31 studies involving 10 intervention measures and a total of 2805 cases were included,including 1377 cases in the observation group and 1428 cases in the control group.The results of the network Meta-analysis showed that in terms of the total efficiency,the curative effect of conventional Western medicine plus the Yupingfeng granules(玉屏风颗粒)was the most significant,and the best probability sequence was listed in descending order as follows:conventional Western medicine plus the Yupingfeng granules,conventional Western medicine plus the Bailing capsules(百令胶囊),conventional Western medicine plus the Huangqi granules(黄芪颗粒),conventional Western medicine plus the Huaiqihuang granules(槐杞黄颗粒),conventional Western medicine plus the Tongkang tablets(童康片),the Huanglong Zhike granules(黄龙止咳颗粒),the Yupingfeng granules,conventional Western medicine,the Huangqi granules,and the Huaiqihuang granules.The recurrence rate of children with CVA receiving conventional Western medicine plus the Huaiqihuang granules was the lowest.The best probability sequence was listed in descending order as follows:conventional Western medicine plus the Huaiqihuang granules,conventional Western medicine plus the Yupingfeng granules,conventional Western medicine plus the Tongkang tablets,conventional Western medicine,and the Yupingfeng granules.In terms of improving the first second forced expiratory volume,the best probability sequence was listed in descending order as follows:conventional Western medicine plus the Huaiqihuang granules,conventional Western medicine plus the Yupingfeng granules,conventional Western medicine plus the Huangqi granules,conventional Western medicine plus the Bailing capsules,the Huanglong Zhike granules,and conventional Western medicine.Conclusion:Compared with conventional Western medicine or single Chinese patent medicine,Chinese patent medicine plus Western medicine is more effective in the treatment of cough variant asthma in children.Among them,the total efficiency of conventional Western medicine plus the Yupingfeng granules is the highest,the recurrence rate of conventional Western medicine plus the Huaiqihuang granules is the lowest,and it shows the most significant effect in ameliorating the first second forced expiratory volume.