摘要
目的:运用网状Meta分析方法比较四种常用中药注射液治疗小儿手足口病的临床疗效与安全性,为临床提供循证依据。方法:全面检索中国期刊全文数据库(CNKI)、中国生物医学数据库(CBM)、维普(VIP)、万方(WanFang Data)中文数据库及The Cochrane library,PubMed,EMbase外文数据库,搜索公开发表的中药注射液热毒宁、痰热清、喜炎平、炎琥宁及利巴韦林注射液(下称热毒宁、痰热清、喜炎平、炎琥宁、利巴韦林)治疗小儿手足口病的临床随机对照试验,检索时间均为自建库至2018年10月30日,筛选出符合纳入标准的研究,按照Cochrane 5.1手册标准对纳入的研究进行文献质量评价与偏倚风险评估,采用ADDIS软件进行网状Meta分析与概率排序。结果:共纳入17项研究,2428例患者。在临床总有效率方面,四种中药注射液皆显著优于利巴韦林(P<0.05),炎琥宁、热毒宁显著优于喜炎平(P<0.05),喜炎平优于痰热清(P<0.05),最佳概率排序:炎琥宁>热毒宁>喜炎平>痰热清>利巴韦林;在口腔溃疡愈合与住院时间方面,喜炎平与热毒宁均显著短于利巴韦林(P<0.05),最佳概率排序:喜炎平=热毒宁>炎琥宁>痰热清>利巴韦林;在退热与皮疹消退时间方面,喜炎平、热毒宁与痰热清皆显著短于利巴韦林(P<0.05),最佳概率排序:喜炎平=热毒宁>痰热清>利巴韦林;在安全性方面,热毒宁、喜炎平显著优于利巴韦林(P<0.05),最佳概率排序:热毒宁>喜炎平>利巴韦林。结论:中药注射液在治疗小儿手足口病方面,炎琥宁临床疗效最高,热毒宁临床安全性最好。本结论仍需要高质量随机对照文献予以进一步验证,并建议结合临床具体情况合理选择中药注射液。
Objective:To evaluate the clinical efficacy and safety of four kinds of commonly used traditional Chinese medicine injection(TCMI)in the treatment of hand-foot-mouth disease(HFMD)in children by the network Meta-analysis,so as to provide evidence for clinical practice.Methods:We searched the Chinese database including Chinese national knowledge infrastructure(CNKI),China biomedical database(CBM),VIP Data,WanFang Data and the English database including.The Cochrane library,PubMed,EMbase from inception to October 30th 2018,to collect publicly available randomized controlled trials of Reduning(热毒宁),Tanreqing(痰热清),Xiyanping(喜炎平),Yanhuning(炎琥宁)and ribavirin in the treatment of HFMD.The studies meeting the inclusion criteria were selected,and the included studies were evaluated for literature quality and bias risk according to the Cochrane 5.1 manual criteria.The ADDIS software was used to perform mesh Meta-analysis and probability ranking.Results:A total of 17 studies were included with 2428 patients.In terms of total clinical effectiveness,the four kinds of TCMI were significantly better than ribavirin(P<0.05),Yanhuning and Reduning were significantly better than Xiyanping(P<0.05),and Xiyanping was better than Tanreqing(P<0.05),best probability ranking:Yanhuning>Reduning>Xiyanping>Tanreqing>ribavirin.In terms of oral ulcer healing and hospital stay,Xiyanping and Reduning were significantly shorter than ribavirin(P<0.05),and the best ranking was:Xiyanping=Reduning>Yanhuning>Tanreqing>ribavirin.In terms of antipyretic and rash resolution time,Xiyanping,Reduning and Tanreqing were significantly shorter than ribavirin(P<0.05),and the best ranking was:Xiyanping=Reduning>Tanreqing>ribavirin.In terms of safety,Reduning and Xiyanping were significantly higher than ribavirin(P<0.05),and the best probability ranking was:Reduning>Xiyanping>ribavirin.Conclusions:In the treatment of HFMD with TCMI,Yanhuning has the highest clinical effect and Reduning has the best clinical safety.This conclusion still needs high-quality randomized controlled literature for further verification,and it is suggested that the TCMI should be reasonably selected in accordance with the specific clinical situation.
作者
于莹
张功
韩涛
黄海量
YU Ying;ZHANG Gong;HAN Tao;HUANG Hailiang(Shandong University of Traditional Chinese Medicine,Jinan 250355,China)
出处
《山东中医药大学学报》
2020年第2期156-163,共8页
Journal of Shandong University of Traditional Chinese Medicine
基金
经方治疗重大疾病作用机制与疗效评价科研创新团队项目(编号:220316)。
