中国中药杂志

2019, v.44(24) 5294-5302

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热毒宁注射液治疗急性气管-支气管炎的系统评价与Meta分析
Systematic review and Meta-analysis of effect of Reduning Injection in treating acute tracheal-bronchitis

党娇娇;吕健;孙梦华;王连心;
DANG Jiao-jiao;LYU Jian;SUN Meng-hua;WANG Lian-xin;Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences;Experimental Research Center,China Academy of Chinese Medical Sciences;

摘要(Abstract):

系统评价热毒宁注射液治疗急性气管-支气管炎的有效性和安全性。计算机检索中国知网、万方、维普、Sino Med、Cochrane Library、Medline、Web of Science从建库至2019年4月发表的期刊文献、学术论文及会议论文,收集热毒宁注射液治疗急性气管-支气管炎的随机对照试验(RCTs)。由2名研究者独立进行文献筛选、数据提取及偏倚风险评估,采用Rev Man 5. 3进行Meta分析。最终纳入14篇随机对照试验文献,涉及1 652例患者。Meta分析结果显示:在临床总有效率方面,热毒宁注射液优于利巴韦林治疗(RR=1. 37,95%CI[1. 28,1. 47],P<0. 000 01);热毒宁注射液联合常规治疗优于常规治疗(RR=1. 14,95%CI[1. 09,1. 19],P<0. 000 01);热毒宁注射液联合阿奇霉素治疗优于阿奇霉素治疗(RR=1. 21,95%CI[1. 07,1. 37],P=0. 002)。在临床症状方面,热毒宁注射液治疗的平均退热时间短于利巴韦林治疗(MD=-1. 68,95%CI[-1. 72,-1. 49],P <0. 000 01);咳嗽消失时间短于利巴韦林治疗(MD=-2. 57,95%CI[-2. 91,-2. 24],P<0. 000 01);肺部啰音消失时间短于利巴韦林治疗(MD=-2. 26,95%CI[-2. 71,-1. 80],P<0. 000 01);热毒宁注射液联合常规治疗肺部啰音消失时间短于单用常规治疗(MD=-1. 77,95%CI[-1. 95,-1. 59],P<0. 000 01)。基于此研究结果,热毒宁注射液治疗可提高临床总有效率,缩短平均退热时间、咳嗽与肺部啰音消失时间,不良反应轻微且发生率低。但鉴于纳入研究质量不高,需采用大样本、设计严谨、符合国际规范的临床试验方案以提高证据质量级别。
To systematically review the effectiveness and safety of Reduning Injection in the treatment of acute tracheal-bronchitis.Four Chinese databases( CNKI,VIP,Wan Fang,Sino Med) and three English databases( Cochrane Library,Medline,Web of Science) were systematically and comprehensively retrieved. The retrieval time was from the establishment of each database to April 2019.Randomized controlled trials( RCTs) for the treatment of acute tracheal-bronchitis with Reduning Injection were collected. Two researchers independently conducted literature screening,data extraction and risk assessment for bias. Rev Man 5.3 software was used for data analysis. Fourteen studies were included,and the total sample size was 1 652 at last. Meta-analysis results show that in the aspect of total clinical effective rate,Reduning Injection was superior to ribavirin( RR = 1. 37,95%CI[1. 28,1. 47],P<0. 000 01); Reduning Injection combined with conventional therapy was better than conventional therapy alone( RR = 1. 14,95% CI[1. 09,1. 19],P <0. 000 01); Reduning Injection combined with azithromycin was better than azithromycin therapy alone( RR = 1. 21,95% CI[1. 07,1. 37],P = 0. 002). In the aspect of clinical symptoms,the time in average fever disappearance of Reduning Injection therapy was shorter than that of ribavirin therapy( MD =-1.68,95%CI[-1. 72,-1. 49],P<0. 000 01); the time in cough disappearance of Reduning Injection therapy was shorter than that of ribavirin therapy( MD =-2. 57,95%CI[-2. 91,-2. 24],P<0. 000 01); the time in lung rales disappearance,Reduning Injection therapy was superior to ribavirin therapy( MD =-2. 26,95% CI[-2. 71,-1. 80],P<0. 000 01),and Reduning Injection combined with conventional therapy was superior to conventional therapy( MD =-1. 77,95% CI[-1. 95,-1. 59],P<0. 000 01). Based on the findings,Reduning Injection can improve the total effective rate,reduce the average time of disappearance in fever,cough and lung rales,with mild adverse reactions and a low incidence. However,the quality of the literatures included is not high,it is necessary to adopt large-sample-size,rigorously designed clinical trial protocols in line with the international standards,in a bid to improve the quality of evidence.

关键词(KeyWords): 热毒宁注射液;急性气管-支气管炎;系统评价;Meta分析
Reduning Injection;acute tracheal-bronchitis;systematic review;Meta-analysis

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基金项目(Foundation): 国家重点研发计划项目(2018YFC1707400,2018YFC1707410)

作者(Author): 党娇娇;吕健;孙梦华;王连心;
DANG Jiao-jiao;LYU Jian;SUN Meng-hua;WANG Lian-xin;Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences;Experimental Research Center,China Academy of Chinese Medical Sciences;

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