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目的评价酚妥拉明治疗小儿毛细支气管炎的疗效和安全性。方法计算机检索Cochrane图书馆,Medline(1950年-2013年),Embase(1980年-2013年),中国生物医学文献数据库(1978年-2013年)、中国知网(1979年-2013年)、万方(1986年-2013年)、维普(1989年-2013年),收集酚妥拉明联合常规方法对比仅用常规方法治疗小儿毛细支气管炎的随机对照试验(RCT),由两名研究者根据纳入与排除标准筛选文献、提取资料并评价质量后,采用RevMan 5.1软件进行Meta分析。结果共纳入13个RCT,1 186例患儿。Meta分析结果显示:在常规治疗基础上加用酚妥拉明,其总有效率[RR=1.30,95%CI(1.15,1.46),P<0.000 1]、平均住院时间[MD=2.15 d,95%CI(2.78,1.53)d,P<0.000 01]、啰音消失的平均时间[MD=1.62 d,95%CI(2.02,1.23)d,P<0.000 01],憋喘消失的平均时间[MD=2.39 d,95%CI(4.64,0.13)d,P=0.04]差异有统计学意义,而气促消失的平均时间差异无统计学意义[MD=0.62 d,95%CI(1.31,0.07)d,P=0.08]。结论在常规治疗基础上加用酚妥拉明治疗小儿毛细支气管炎时,其疗效疗效优于仅采用常规治疗,在缓解啰音、憋喘等临床症状上起效更快。而在安全性方面证据不足,需要进一步的研究。
Objective To evaluate the efficacy and safety of phentolamine in the treatment of pediatric bronchiolitis. Methods The Cochrane Library, Medline (1950-2013), Embase (1980-2013), China Biomedical Literature Database (1978-2013), China Knowledge Network (1979-2013), (1986-2013), Vip (1989-2013), a randomized controlled trial (RCT) of phentolamine combined with conventional methods versus conventional methods for the treatment of pediatric bronchiolitis was collected by two investigators After inclusion and exclusion of standard screening literature, data extraction and quality evaluation, Meta-analysis was performed using RevMan 5.1 software. Results A total of 13 RCTs and 1 186 children were enrolled. The results of Meta-analysis showed that the total effective rate of phentolamine plus conventional treatment was 1.30, 95% CI (1.15, 1.46), P <0.0001, mean length of stay [MD = 2.15 d, 95% CI (2.78,1.53) d, P <0.000 01]. The mean time to the disappearance of rales (MD = 1.62 d, 95% CI 2.02,1.23 d, P 0.0001) (MD = 2.39 d, 95% CI (4.64,0.13) d, P = 0.04]. There was no significant difference in the average time of disappearance of shortness of breath (MD = 0.62 d, 95% CI 1.31, 0.07) d, P = 0.08]. Conclusions The curative effect of phentolamine on children with bronchiolitis on the basis of conventional treatment is better than that of conventional treatment, and it has a faster onset of clinical symptoms such as atrial fibrillation and atrial fibrillation. Inadequate evidence of safety requires further research.