摘要
目的系统评价清金化痰方治疗社区获得性肺炎(CAP)的有效性和安全性。方法检索中国生物医学文献数据库(CBM)、维普中文科技期刊数据库(VIP)、中国知网(CNKI)、万方数据库(WANFANG)、PubMed及Cochrane Library中采用清金化痰方治疗CAP的随机对照试验,检索文献时限均从建库至2019年6月1日。由两位研究者独立筛选文献、提取资料和评价纳入研究的偏倚风险后,采用RevMan 5.3软件对临床总有效率、退热时间、咳嗽咯痰消失时间、肺部啰音消失时间、C反应蛋白(CRP)、白细胞计数(WBC)、中性粒细胞比例(NEUT)、降钙素原(PCT)、住院时长进行Meta分析。结果共纳入13项随机对照试验,共978例患者,13项研究方法学质量均偏低。Meta分析结果显示:清金化痰方联合常规西医治疗的有效率是常规西医治疗的1.14倍[RR=1.14,95%CI(1.09,1.19),P<0.001];与常规西医治疗比较,清金化痰方联合常规西医治疗可缩短退热时间[-0.88(-1.33,-0.42)]、咳嗽咯痰消失时间[-1.49(-2.04,-0.94)]、肺部啰音消失时间(天)[-1.01(-1.21,-0.81)]及住院时长[-2.54(-4.06,-1.03)],降低CRP[-5.99(-9.68,-2.30)]、WBC[-1.74(-2.57,-0.92)]、NEUT[-1.50(-2.94,-0.06)],且差异均有统计学意义(P<0.05),但两组在改善PCT方面差异无统计学意义(P>0.05)。结论清金化痰方联合常规西医治疗能提高CAP的临床疗效并更好地改善相关炎症指标,但受研究质量的限制,此结论仍待更多高质量研究进行确证。
Objective To systemically evaluate the effectiveness and safety of Qingjin Huatan Recipe for community acquired pneumonia(CAP).Methods Randomize controlled trials(RCTs)of Qingjin Huatan Recipe(清金化痰方)for treating CAP were searched from databases including CBM,VIP,CNKI,Wanfang,PubMed and Cochrane Library from their inception dates to June 1 st,2019.Two researchers in duplicate screened the literature,extracted the data and assessed the risk of bias independently.RevMan 5.3 software was used to synthesize the data on clinical effective rate,time to disappearance of fever,cough and expectoration,and lung rales,C-reactive protein(CRP),white blood cell count(WBC),percentage of neutrophils(NEUT),procalcitonin(PCT),and length of hospital stay.Results Totally,13 RCTs of 978 participants were included.The methodological quality of all the 13 RCTs were relatively low.Meta-analysis results showed that the effective rate of Qingjin Huatan Recipe integrated with basic Western medicine was significantly higher than that of Western medicine alone[risk ratio(RR)1.14,95%confidence interval(CI)1.09 to 1.19,P<0.001].Moreover,the integration of Qingjin Huatan Recipe and Western medicine can significantly shorten the time to disappearance of fever[standard mean difference(SMD)-0.88,95%CI-1.33 to-0.42],cough and expectoration(SMD-1.49,95%CI-2.04 to-0.94),and lung rales(days)(SMD-1.01,95%CI-1.21 to-0.81),shorten the length of hospital stay(SMD-2.54,95%CI-4.06 to-1.03),as well as decrease the CRP(SMD-5.9,95%CI-9.68 to-2.30),WBC(SMD-1.74,95%CI-2.57 to-0.92),and NEUT(SMD-1.50,95%CI-2.94 to-0.06)when compared to Western medicine alone(P<0.05).However,there was no significant difference in the improvement of PCT between groups(P>0.05).Conclusion Qingjin Huatan Recipe integrated with conventional Western medicine have better clinical effect and can improve the inflammation related indicators when treating patients with CAP.However,limited by the quality of the included studies,this conclusion should be confirmed with further more qualified researches.
作者
李云
张洪春
刘剑
王辛秋
李颖
LI Yun;ZHANG Hongchun;LIU Jian;WANG Xinqiu;LI Ying(Beijing University of Chinese Medicine,Beijing,100029;Center of Respiratory Medicine/National Clinical Research Center for Respiratory Diseases,China-Japan Friendship Hospital)
出处
《中医杂志》
CSCD
北大核心
2021年第1期37-43,共7页
Journal of Traditional Chinese Medicine
基金
科技部重大新药创制科技重大专项(2018ZX09721004-006)。
关键词
社区获得性肺炎
清金化痰方
系统评价
community acquired pneumonia
Qingjin Huatan Recipe(清金化痰方)
systematic review
