中国中药杂志

2021, v.46(04) 1000-1009

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连花清瘟辅助治疗成人肺炎有效性和安全性的Meta分析与系统综述
Meta-analysis and systematic review of efficacy and safety of Lianhua Qingwen in adjuvant treatment of adult pneumonia

卢肇骏;吴丽引;牟艳嫣;段涵敏;陈如程;肖尧;郑卫军;
LU Zhao-jun;WU Li-yin;MOU Yan-yan;DUAN Han-min;CHEN Ru-cheng;XIAO Yao;ZHENG Wei-jun;School of Public Health,Zhejiang Chinese Medical University;

摘要(Abstract):

系统评价连花清瘟治疗成人肺炎的有效性和安全性。通过检索PubMed、EMbase、万方数据库(Wanfang)、维普数据库(VIP)、中国知网数据库(CNKI)收集连花清瘟辅助常规西医疗法治疗肺炎的随机对照试验,检索时限均从建库至2020年3月,由2位研究者独立进行文献筛选和资料提取工作并进行交叉核对,如遇分歧通过第3位研究者仲裁解决。结局指标包括临床总有效率、症状改善时间与不良反应/事件发生率等。采用R 3.6.1进行Meta分析,RevMan 5.3进行质量评价。最终纳入22项研究,共2 007例患者,其中试验组1 017例,对照组990例。Meta分析结果显示试验组临床总有效率高于对照组(RR=1.11, 95%CI[1.08, 1.15],P<0.001),退热时间(MD=-1.81, 95%CI[-2.42,-1.21],P<0.001)、咳嗽持续时间(MD=-2.32, 95%CI[-2.89,-1.76],P<0.001)、啰音持续时间(MD=-2.19, 95%CI[-2.74,-1.63],P<0.001)、影像学转归时间(MD=-2.17, 95%CI[-2.76,-1.58],P<0.001)及治疗后CRP指标(MD=-4.07, 95%CI[-6.39,-1.75],P<0.001)均显著低于对照组,但暂不能证明试验组安全性优于对照组(RR=0.84, 95%CI[0.57, 1.24],P=0.382)。结果表明连花清瘟辅助常规西医疗法治疗肺炎可提高临床总有效率,缩短退热时间、咳嗽时间、啰音持续时间及影像学转归时间,改善CRP指标,加快肺炎患者的康复速度。然而该研究所纳入的文献质量偏低,所得结论仍需要更多高质量、多中心、严格设计的临床随机对照试验来进一步证实。
To systematically evaluate the clinical efficacy and safety of Lianhua Qingwen in the treatment of adult pneumonia. The randomized controlled trial of Lianhua Qingwen combined with conventional Western medicine in the treatment of pneumonia were retrieved from PubMed, EMbase, Wanfang database, VIP database, and CNKI from the establishment of database to March 2020. Two researchers independently conducted literature screening and data extraction, and the third researcher was in charge of arbitration in case of any disagreement. Outcome indicators included total clinical effective rate, symptom improvement time, and incidence of adverse events. R 3.6.1 was used for Meta-analysis, and RevMan 5.3 was used for quality evaluation. Twenty-two studies were included, with a total of 2 007 patients, including 1 017 patients in the experimental group and 990 patients in the control group. The results showed that the total clinical effective rate of the experimental group was higher than that of the control group(RR=1.11, 95%CI[1.08, 1.15], P<0.001), and the antifebrile time(MD=-1.81, 95%CI[-2.42,-1.21], P<0.001), cough duration(MD=-2.32, 95%CI[-2.89,-1.76], P<0.001), rale duration(MD=-2.19, 95%CI[-2.74,-1.63], P<0.001), imaging recovery time(MD=-2.17, 95%CI[-2.76,-1.58], P<0.001) and post-treatment CRP(MD=-4.07, 95%CI[-6.39,-1.75], P<0.001] were all significantly lower than those of the control group. However, it did not proved that the experimental group was safer than the control group(RR=0.84, 95%CI[0.57, 1.24], P=0.382). The results confirmed that Lianhua Qingwen combined with conventional Western medicine in the treatment of pneumonia could improve the clinical treatment efficiency, shorten the time of fever, cough, rale disappearance and imaging recovery, improve CRP index and accelerate the recovery of pneumonia patients. However, the literatures included in this study had a low quality, and the conclusions still need to be further confirmed by more high-quality, multi-center, rigorously designed randomized controlled trial.

关键词(KeyWords): 连花清瘟;肺炎;Meta分析;系统评价;有效性;安全性
Lianhua Qingwen;pneumonia;Meta-analysis;systematic review;efficacy;safety

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 卢肇骏;吴丽引;牟艳嫣;段涵敏;陈如程;肖尧;郑卫军;
LU Zhao-jun;WU Li-yin;MOU Yan-yan;DUAN Han-min;CHEN Ru-cheng;XIAO Yao;ZHENG Wei-jun;School of Public Health,Zhejiang Chinese Medical University;

Email:

DOI: 10.19540/j.cnki.cjcmm.20200508.501

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