中医药内外合治法治疗小儿病毒性肺炎有效性的Meta分析

Meta-analysis of the effectiveness of the combined method of internal and external Chinese medicine in the treatment of pediatric viral pneumonia

目的系统评价中医药内外合治综合法治疗小儿病毒性肺炎的临床有效性。方法在CNKI、VIP、CBM、Wanfang四大中文库以及PubMed、EMBASE、Cochrane library数据库中检索中医药内外合治小儿病毒性肺炎相关的随机对照试验,时限均为建库至2022年5月。经Endnote X9软件去重,筛选文献并提取数据,进行质量评价。采用RevMan5.4软件对数据进行Meta分析。结果共纳入5篇文献,总样本量为860例。Meta分析结果显示,与对照组相比,内外合治法治疗儿童病毒性肺炎总有效率明显高于对照组([OR=6.17,95%CI(3.50,10.86)],P<0.00001)。肺啰音消失时间[MD=-2.07,95%CI(-2.99,-1.15),P<0.0001],喘憋消失时间[MD=-1.17,95%CI(-2.11,-0.24),P=0.01],咳嗽消失时间[MD=-2.11,95%CI(-3.83,-0.39),P=0.02],咳痰消失时间[MD=-1.89,95%CI(-2.33,-1.44),P<0.00001],结果均显示内外合治法组效果优于对照组。结论运用内外合治综合疗法治疗小儿病毒性肺炎总体疗效优势显著,对于缩短肺部啰音消失时间、喘憋时间及咳嗽、咳痰消失时间效果明显。

Objective To systematically evaluate the clinical effectiveness of the combined method of internal and external Chinese medicine in the treatment of pediatric viral pneumonia.Methods The random controlled trials related to the combined internal and external treatment of Chinese medicine for pediatric viral pneumonia were searched in four major Chinese databases,CNKI,VIP,CBM and Wanfang,as well as in PubMed,EMBASE and Cochrane library databases,all with a time period from their establishment to May 2022.The literature was de-duplicated by Endnote X9 software and screened,and data was extracted for quality evaluation.Meta-analysis of the data was performed using RevMan 5.4 software.Results A total of 5 papers with a total sample size of 860 cases were included.Meta-analysis showed that the overall effectiveness of the combined internal and external treatment for childhood viral pneumonia was significantly higher than that of the control group[OR=6.17,95%CI(3.50,10.86)](P<0.00001).The time to disappearance of pulmonary rales[MD=-2.07,95%CI(-2.99,-1.15),P<0.0001],time to disappearance of wheezing[MD=-1.17,95%CI(-2.11,-0.24),P=0.01],time to disappearance of cough[MD=-2.11,95%CI(-3.83,-0.39),P=0.02]and time to disappearance of cough[MD=-1.89,95%CI(-2.33,-1.44),P<0.00001]were all better in the combined internal and external treatment method group than in the control group.Conclusion The overall efficacy of combined internal and external treatment for pediatric viral pneumonia has significant advantages and is effective in shortening the time to disappearance of pulmonary rales,wheezing and cough and sputum.