柴胡类方治疗发热性疾病临床疗效的Meta分析

A Meta-analysis of the therapeutic efficacy of Chaihu classic prescriptions on fever diseases

目的:评价柴胡类方治疗发热性疾病的临床疗效及调节机制。方法:检索中国知网、维普、万方数据库、PubMed数据库、Embase数据库和Cochrane数据库自建库至2022年5月20日收录的柴胡类方治疗发热性疾病的临床随机对照试验研究。对照组多为解热抗炎等常规西药,治疗组采用柴胡类方加西药治疗。观察指标主要是临床总有效率、体温调节指标[降温时间,降温幅度)和免疫学相关指标[治疗前后CD4+细胞百分比、CD8+细胞百分比、干扰素(Interferon,IFN)-γ水平和白细胞介素(Interleukin,IL)-4水平的变化]。由2位研究人员独立进行文献筛选、数据提取和质量评价。采用RevMan5.3软件进行Meta分析。结果:本研究共纳入20个随机对照试验,2115例患者。柴胡类方和西药比较,显著提高了临床总有效率(OR=4.40),显著缩短了体温下降至正常所需的时间(MD=-22.19),增加了48h体温下降幅度(MD=0.58),提高了CD4+细胞百分比(MD=5.21),增加了抗炎因子IFN-γ水平(MD=5.94),减少了炎症因子IL-4水平(MD=-3.99),以上指标差异均有统计学意义。结论:当前证据表明,柴胡类方治疗发热性疾病较西药能显著提高临床总有效率且退热效果优于西药,其作用机制可能与调节机体免疫功能相关。

Objective:To evaluate the clinical efficacy of the Chaihu classic prescriptions compared with conventional Western medicine on fever diseases.Methods:The related literature was searched in Chinese and English databases such as CNKI,VIP,Wanfang,PubMed,Embase,and the Cochrane Library.The retrieval time was from the establishment of the database to May 2022.Randomized controlled trials of the Chaihu classic prescriptions on fever diseases were collected.The control group was mainlyO given routine western medicines.The treatment group was treated with Chaihu classic prescriptions plus western medicine.The main outcomes were total clinical efficacy,body temperature recover time and level,CD4+cell percentage,CD8+cell percentage,IFN-γand IL-4 levels.Literature selection,data extraction and quality evaluation were carried out independently by two researchers.A Meta-analysis was performed using RevMan 5.3 statistical software.Results:A total of 20 randomized controlled trials were included,including 2115 patients.Compared with western medicine,Chaihu classic prescriptions significantly improved the total clinical efficacy(OR=4.40),significantly shortened the time required for body temperature recovery,MD=-22.19,significantly increased the body temperature decrease levels in 48 h,MD=0.58,significantly increased the percentage of CD4+cells,MD=5.21,significantly increased the anti-inflammatory factor IFN-γlevel,MD=5.94,and significantly decreased the inflammatory factor IL-4 level,MD=-3.99.Conclusion:The current evidences show that the Chaihu classic prescription can significantly improve the total clinical efficacy and body temperature recovery on fever diseases compared with western medicine.The effects may be attributed to its regulation of immune system.