中医外治法治疗小儿轮状病毒性肠炎的Meta分析

Meta-Analysis of External Treatment of Infantile Rotavirus Enteritis with External Treatment of Traditional Chinese Medicine

目的系统评价中医外治法治疗小儿轮状病毒性肠炎的临床疗效,为临床提供证据。方法运用计算机检索CNKI、万方、VIP、Pubmed、Embase、Cochrane library、CBM等中英文数据库,收集建库起至2022年1月期间所有关于中医外治法治疗小儿轮状病毒性肠炎的中文随机对照试验的文献。干预方式包括针灸、穴位注射、穴位贴敷、中药灌肠、推拿等。结局指标包括临床总有效率、证候总积分、止泻时间、大便RV抗原转阴率等。2名人员共同筛选并应用Review Manager 5.3分析整理。结果最终纳入20个RCT试验,共计2599例。Meta分析结果显示,在对症治疗的基础上,中医外治组的总有效率高于对照组(OR=5.63;95%CI:4.27,7.42;P<0.001),且可明显缩短止泻时间(MD-2.31,95%CI:-2.40,-2.21;I^(2)=0%),有效提高RV抗原转阴率(OR=2.58;95%CI:1.55,4.30;P<0.003),改善患者中医证候积分(MD-0.58,95%CI:-0.85,-0.3;I^(2)=0%)。漏斗图不对称提示纳入文献有发表偏倚风险的可能。结论中医外治法治疗小儿轮状病毒性肠炎疗效可能优于常规西药或单一疗法,但仍需大样本、多中心的高质量RCT研究加以验证。

Objective To systematically evaluate the clinical efficacy of external treatment of traditional Chinese medicine in the treatment of infantile rotavirus enteritis,and to provide evidence for clinical.Methods Chinese and English databases such as CNKI,Wanfang,VIP,Pubmed,Embase,Cochrane Library and CBM were searched by computer,the literature on external treatment of rotavirus enteritis in children was collected from the establishment of the database to January 2022.The literature was collected at random controlled trial.Intervention methods include acupuncture,acupoint injection,acupoint application,Chinese Medicine Enema,massage and so on.The outcome indexes included the total clinical efficiency,the integral of syndrome,the time of antidiarrheal and the negative rate of RV Antigen in stool.Data were analyzed using Review Manager 5.3 after screening by two researchers.Results A total of 2599 cases were included in 20 RCT tests.The results of Meta-analysis showed that,on the basis of symptomatic treatment,the total effective rate of TCM external treatment group was higher than that of Control Group(or 5.63;95%CI:4.27,7.42,P<0.001),and the antidiarrheal time was significantly shortened(MD-2.31,95%CI:-2.40,-2.21;I^(2)=0%),the rate of RV Antigen negative conversion(or 2.58;95%CI:1.55,4.30,P<0.003)and the score of Traditional Chinese Medicine syndrome were improved(MD-0.58,95%CI:-0.85,-0.3;I^(2)=0%).Funnel-plot analysis was used to analyze the asymmetry of inclusion literature,which suggested the possibility of publication bias in inclusion research.Conclusion External Treatment of traditional Chinese medicine may be better than conventional western medicine or single therapy,and higher safety,less adverse reactions,but still need a large sample,multi-center high-quality RCT study to verify.