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目的:系统评价痰热清注射液治疗小儿支气管肺炎的疗效和安全性,为临床治疗提供循证依据。方法:计算机检索Cochrane Library,Embase,Pubmed,CBM,CNKI,VIP和Wanfang等数据库,查找以痰热清注射液为干预措施治疗小儿支气管肺炎的随机对照试验(RCT),检索时限均从建库至2015年6月。研究者按照纳入与排除标准独立筛选文献、提取资料并进行方法学质量评价后,采用RevMan5.2软件进行统计分析。结果:共纳入19篇文献,合计1 943例患者。Meta分析结果显示,痰热清注射液联合西医常规疗法在临床总有效率[OR=3.76,95%CI(2.68,5.28),P<0.000 01],退热时间[MD=-1.28,95%CI(-1.51,-1.05),P<0.000 01],咳嗽消失时间[MD=-1.72,95%CI(-2.13,-1.31),P<0.000 01],肺部啰音消失时间[MD=-1.55,95%CI(-1.95,-1.15),P<0.000 01],X线片恢复正常时间[MD=-2.33,95%CI(-3.19,-1.47),P<0.000 01]及平均住院时间[MD=-1.89,95%CI(-2.65,-1.12),P<0.000 01]等方面均优于对照组。纳入的19项研究中痰热清的不良反应表现轻微,均无严重不良反应发生。结论:基于当前的临床证据,在常规治疗的基础上联用痰热清注射液治疗小儿支气管肺炎可以提高疗效,且较为安全。但由于纳入的研究质量有限,尚需设计更多严谨的、大样本的随机双盲对照试验加以验证。
Objective: To systematically evaluate the efficacy and safety of Tanreqing injection in the treatment of bronchial pneumonia in children and provide evidence base for clinical treatment. Methods: The databases of Cochrane Library, Embase, Pubmed, CBM, CNKI, VIP and Wanfang were searched by computer to find out the randomized controlled trial (RCT) of Tanreqing Injection as an intervention in children with bronchopneumonia. June 2015. According to the criteria of inclusion and exclusion, the researchers screened the literature independently, extracted the data and evaluated the methodological quality. The data were analyzed by RevMan5.2 software. Results: A total of 19 articles were included, totaling 1 943 patients. The results of Meta analysis showed that the total clinical effective rate of Tanreqing Injection combined with conventional western medicine was significantly lower than that of conventional therapy (OR = 3.76, 95% CI 2.68, 5.28, P 0.0001) CI (-1.51, -1.05), P <0.000 01], cough disappearance time [MD = -1.72,95% CI (-2.13, -1.31), P <0.000 01] -1.55, 95% CI -1.95, -1.15, P <0.000 01], normal time of X-ray recovery [MD = -2.33, 95% CI (-3.19, -1.47), P <0.000 01] Hospital stay [MD = -1.89, 95% CI (-2.65, -1.12), P <0.000 01] were superior to the control group. Among the 19 studies included, the adverse reactions of Tanreqing were mild with no serious adverse reactions. Conclusion: Based on the current clinical evidence, the combination of Tanreqing Injection with bronchial pneumonia on the basis of routine treatment can improve the curative effect and is safer. However, due to the limited quality of the included studies, more rigorous randomized, double-blind, controlled trials of large samples need to be designed.