中国中药杂志

2019, v.44(24) 5313-5321

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痰热清注射液治疗慢性支气管炎急性发作期的Meta分析
Meta-analysis of randomized controlled trials on effect of Tanreqing Injection combined with Western medicine on acute exacerbation of chronic bronchitis

高丽霓;吕健;王志飞;于丹丹;孙梦华;
GAO Li-ni;LYU Jian;WANG Zhi-fei;YU Dan-dan;SUN Meng-hua;Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences;Wangjing Hospital,China Academy of Chinese Medical Sciences;

摘要(Abstract):

为系统评价痰热清注射液治疗慢性支气管炎急性发作期(acute exacerbation of chronic bronchitis,AECB)的有效性和安全性,检索CNKI,Wan Fang,VIP,CBM,Medline,Cochrane Library,EMbase,Web of Science,筛选出采用痰热清注射液治疗AECB的随机对照试验(randomized controlled trial,RCT)。根据Cochrane系统评价手册对所纳入研究进行质量评价,采用RevMan 5. 3软件对最终纳入的研究进行Meta分析。最终纳入23个RCT,共1 901例患者,试验组952例,对照组949例。Meta分析结果显示,痰热清注射液联合常规治疗AECB的退热时间少于仅使用常规治疗(RR=-1. 03,95%CI[-1. 45,-0. 62],P<0. 000 01),痰热清注射液联合常规治疗AECB总有效率优于仅使用常规治疗(RR=1. 17,95%CI[1. 13,1. 23],P<0. 000 01);痰热清注射液联合左氧氟沙星治疗AECB总有效率优于单用左氧氟沙星(RR=1. 23,95%CI[1. 08,1. 41],P=0. 002);痰热清注射液联合头孢呋辛治疗AECB总有效率优于单用头孢呋辛(RR=1. 22,95%CI[1. 05,1. 42],P=0. 01);痰热清注射液联合头孢哌酮钠舒巴坦钠治疗AECB总有效率优于单用头孢哌酮钠舒巴坦钠(RR=1. 22,95%CI[1. 04,1. 44],P=0. 02)。止咳时间、咳痰消失时间等结局指标由于纳入研究间异质性较大,采用描述性分析。不良反应主要为皮疹、头晕、胃肠道反应等,反应均较轻微。基于现有数据与分析结果,痰热清注射液联合西药治疗AECB较仅使用西药有更好的疗效,在改善临床症状上更具有优势。鉴于纳入研究存在数量少、样本量小、方法学质量低等局限,该研究结果尚需高水平的临床试验证实。
To systematically review the effectiveness and safety of Tanreqing Injection in treating acute exacerbation of chronic bronchitis( AECB). CNKI,Wan Fang,VIP,CBM,Medline,Cochrane Library,EMbase and Web of Science were retrieved,and randomized controlled trials for the effect of Tanreqing Injection in the treatment of acute exacerbation of chronic bronchitis were screened. The quality of the included studies was evaluated according to the Cochrane Handbook's evaluation criteria. The data was analyzed by RevMan 5.3. Totally 23 RCTs involving 1 901 patients were included,including 952 in the experimental group and 949 in the control group. The Meta-analysis demonstrated that in terms of the disappearance time of fever,the group of Tanreqing Injection combined with the conventional therapy was superior to conventional therapy group( RR =-1. 03,95%CI[-1. 45,-0. 62],P<0. 000 01); compared with the conventional therapy group,the group of Tanreqing Injection combined with conventional therapy had a higher cure rate for AECB( RR = 1. 17,95% CI[1. 13,1. 23],P < 0. 000 01). The group of Tanreqing Injection combined with levofloxacin had a higher cure rate for AECB than the levofloxacin group( RR = 1. 23,95% CI[1. 08,1. 41],P = 0. 002). The group of Tanreqing Injection combined with cefuroxime had a higher cure rate for AECB than the cefuroxime group( RR = 1. 22,95%CI[1. 05,1. 42],P = 0. 01).The group of Tanreqing Injection combined with cefoperazone sodium and sulbactam sodium had a higher cure rate for AECB than the group of cefoperazone sodium and sulbactam sodium( RR = 1. 22,95% CI[1. 04,1. 44],P = 0. 02). The outcomes of disappearance time of cough and expectoration had a huge heterogeneity,so were used for descriptive analysis. The adverse reactions mainly included skin rash,dizziness,gastrointestinal reactions. Based on the available data and the results of the analysis,the group of Tanreqing Injection combined with Western medicine has a higher cure rate for acute exacerbation of chronic bronchitis,and the effect in reducing symptoms disappearance time. In view of the limited number of included studies,small sample size and low methodological quality,the results of this study need to be confirmed with high-level clinical trials.

关键词(KeyWords): 痰热清注射液;慢性支气管炎急性发作;系统评价;Meta分析
Tanreqing Injection;acute exacerbation of chronic bronchitis;systematic review;Meta-analysis

Abstract:

Keywords:

基金项目(Foundation): 国家重点研发计划项目(2018YFC1707410);; 中国中医科学院研究生教育教学改革研究项目(JG201703)

作者(Author): 高丽霓;吕健;王志飞;于丹丹;孙梦华;
GAO Li-ni;LYU Jian;WANG Zhi-fei;YU Dan-dan;SUN Meng-hua;Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences;Wangjing Hospital,China Academy of Chinese Medical Sciences;

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