中成药治疗急性咽炎数据挖掘及网状Meta分析

Net Meta-analysis and data mining of patients with acute pharyngitis managed with Chinese medicine

目的挖掘中成药治疗急性咽炎的使用现状及比较常用药物疗效。方法通过检索PubMed、Embase、Cochrane Library、web of science、中国知网、万方、中国生物医学文献数据库和维普中文期刊服务平台,搜集建库至2022年4月20日以来中成药治疗急性咽炎的临床研究,使用stata软件及R语言软件进行网状Meta分析及数据挖掘。结果数据挖掘共纳入202项临床研究,141种中成药,其中西瓜霜制剂为研究频次最高者,其次为疏风解毒胶囊。主治症状挖掘得出肺胃热盛证主要表现为咽喉肿痛、口咽干燥、牙龈肿痛等,风热外袭证主要表现为咽部红肿、咽干、声哑音嘶、发热等。Meta分析纳入33项随机对照研究,14种干预措施,8种中成药,直接Meta分析显示疏风解毒胶囊联合抗生素、西瓜霜制剂、清咽滴丸联合抗生素、瓜子金、银黄制剂均较单用抗生素疗效更佳。网状Meta分析显示有效率统计学排序前三位为银黄制剂(SUCRA=0.87)、高于疏风解毒胶囊联合抗病毒药物(SUCRA=0.85)高于西瓜霜制剂(SUCRA=0.72)。结论目前已发表中成药治疗急性咽炎的临床研究中使用最多的为西瓜霜制剂,证型以风热外袭为主。纳入Meta分析的中成药疗效均非劣于抗生素单用,其中银黄制剂拥有最佳的有效率。

Objective This study aimed to explore the use of Chines-patent medicines in managing patients with acute pharyngitis,and to compare their efficacy against commonly used drugs.Methods Clinical studies of Chinese-patent medicines for acute pharyngitis,published until April 20,2022,were collected from PubMed,Embase,Cochrane Library,web of science,CNKI,Wanfang,Sinomed,and VIP.Meta-analysis and data mining were done with the Stata software and R software.Results A total of 202 clinical studies and 141 types of Chinese-patent medicines were collected.Of which,a watermelon cream preparation was the most frequently studied Chinese-patent medicine,followed by Shufengjiedu capsules.The main symptoms of exuberant lung-stomach heat included sore swollen throat,dry throat and thirst,and gum swelling and pain.On the other hand,the main symptoms of wind-heat assailing the outer body included pharyngeal redness and swelling,dry throat,hoarseness,hissing,and fever.A total of 33 randomized control trials,14 interventions,and eight types of Chinese-patent medicines were included in our meta-analysis,which showed that Sufengjiedu capsules combined with antibiotics,watermelon cream preparation,Qingyan drops combined with antibiotics,Guaizijin,and Yinhuang preparations were more effective than single vse antibiotics.Moreover,our net meta-analysis revealed that the Yinhuang preparation(SUCRA=0.87),sufengjiedu capsule combined with antiviral drugs(SUCRA=0.85),and watermelon cream preparation(SUCRA=0.72)had the greatest efficiency rates.Conclusion At present,the most used clinical research on the treatment of acute pharyngitis with Chinese-patent medicine involves the use of watermelon cream preparation.The most common pattern is wind-heat assailing the outer body.Our metanalysis revealed that the efficacy of Chinese patent medicines was non-inferior to that of antibiotics alone.Of which,the Yinhuang preparation displayed the best efficacy.