八正散加减治疗尿路感染的Meta分析

Meta-analysis of Bazheng Powder in the Treatment of Urinary Tract Infection

目的:系统评价中药复方八正散治疗尿路感染的临床疗效。方法:通过检索中国知网、万方、维普、Pubmed、Cochrane Library、EMbase外文数据库2000年1月至今发表的关于中药复方八正散联合抗生素治疗尿路感染的临床随机对照试验文献,文献质量评价分别采用Cochrane和Jadad评分方法,并应用Review Manager 5.4软件进行数据分析。结果:共纳入14篇研究,对1377例患者数据进行Meta分析,结果显示与单用抗生素相比,中药复方八正散联合抗生素治疗尿路感染能提高临床总有效率[OR=4.55,95%CI(2.99,6.94),P<0.00001]、细菌清除率[OR=2.21,95%CI(1.06,4.62),P=0.04],同时有效降低不良反应发生率[OR=0.36,95%CI(0.16,0.79),P=0.01],治疗组在降低尿白细胞数量[SMD=-2.76(-3.19,-2.33),P<0.00001]方面优于对照组;在降低临床症状评分,包括尿频症状评分[MD=-0.73 (-1.01,-0.46),P<0.00001]、尿痛症状评分[MD=-0.67(-1.02,-0.32),P=0.0002]、小腹拘急症状评分[MD=-0.89(-0.95,-0.83),P<0.000 01]方面均优于对照组。结论:当前证据显示,运用中药复方八正散联合抗生素治疗尿路感染具有良好的临床疗效,尤其能够缓解临床尿频、尿痛、小腹拘急症状,提高患者生活质量。此结论仍需更大样本、更高质量临床试验去进一步验证。

Objective To evaluate the clinical efficacy of Bazheng Powder in the treatment of urinary tract infection.Methods By searching the clinical randomized controlled trial literatures on Bazheng Powder combined with antibiotics in the treatment of urinary tract infection published on CNKI,Wanfang,VIP,Pubmed,Cochrane Library and EMbase foreign language databases from January 2000 to now,Cochrane and Jadad scoring criteria were used for literature quality evaluation,and Review Manager 5.4 software was used for data analysis.Results A total of 14 literatures were included,and a meta-analysis was performed on 1377 patients.The results of meta-analysis showed that compared with antibiotics alone,Bazheng Powder combined with antibiotics in the treatment of urinary tract infection could improve the total clinical response rate[OR=4.55,95%CI(2.99,6.94),P<0.00001]、bacterial clearance rate[OR=2.21,95%CI(1.06,4.62),P=0.04],and effectively reduce the incidence of adverse reactions[OR=0.36,95%CI(0.16,0.79),P=0.01],The treatment group was better than the control group in reducing the urinary white blood cell count[SMD=-2.76(-3.19,-2.33),P<0.00001].The score of clinical symptoms decreased,including frequency of urination symptom score[MD=-0.73(-1.01,-0.46),P<0.00001],pain of urine symptom score[MD=-0.67(-1.02,-0.32),P=0.0002],symptom score of acute abdominal arrest[MD=-0.89(-0.95,-0.83),P<0.00001],were better than the control group.Conclusion Current evidence shows that the use of traditional Chinese medicine compound Bazheng Powder combined with antibiotics in the treatment of urinary tract infection has good clinical efficacy,especially can relieve clinical symptoms of frequent urination,urinary pain,residual urination,and improve the quality of life of patients.This conclusion still needs to be further verified by larger samples and higher quality clinical trials.