[摘要] 目的 ?u价连花清瘟胶囊治疗社区获得性肺炎的效果及安全性。 方法 检索Medline、The Cochrane Library、PubMed、万方数据库、维普数据库、中国知网、中国生物医学文献数据库,收集连花清瘟胶囊联合常规西医疗法治疗社区获得性肺炎的随机对照试验,检索时限均为建库到2016年12月。按照纳入及排除标准筛选研究,参照Jadad记分方法评价文献质量,Meta分析采用Rev Man 5.3软件。 结果 共纳入随机对照试验6篇。连花清瘟胶囊联合治疗有效率显著高于单纯西医治疗(OR=1.70,95%CI:1.15~2.52,P=0.008),退热时间(WMD=-2.33,95%CI:-2.52~-2.13,P 0.05)。 结论 连花清瘟胶囊联合治疗社区获得性肺炎可改善有效率,缩短症状缓解时间、影像转归时间,不良反应少,对社区获得性肺炎有很好的辅助治疗作用。受文献质量以及数量影响,上述结论仍需扩大样本量,选取高质量文献进行进一步的验证。
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[关键词] 连花清瘟胶囊;社区获得性肺炎;系统评价;Meta分析
[中图分类号] R563 [文献标识码] A [文章编号] 1673-7210(2017)11(c)-0133-05
A Meta-analysis of the effect and safety of Lianhua Qingwen Capsules in the treatment of community acquired pneumonia
ZHOU Zhen WANG Sumei LIU Yanping
Department of Respiratory Medicine, the 174th Hospital of PLA, Fujian Province, Xiamen 361003, China
[Abstract] Objective To evaluate the efficacy and safety of Lianhua Qingwen Capsules in the treatment of community acquired pneumonia. Methods Medline, The Cochrane Libary, PubMed, Wanfang Database, VIP database, CNKI and CBM were searched to collect the randomized controlled trials on Lianhua Qingwen Capsule combined with conventional western medicine therapy in treating community acquired pneumonia from built library to December 2016. The studies were screened according to the inclusion and exclusion criteria, the quality of the literature was evaluated by reference to the Jadad score method, and Meta-analysis was performed by Rev Man 5.3 software. Results A total of 6 randomized controlled trials were included. The effective rate of combined treatment with Lianhua Qingwen Capsule was significantly higher than that of western medicine treatment alone (OR = 1.70, 95%CI: 1.15-2.52, P=0.008), the antipyretic time (WMD = -2.33, 95%CI: -2.52 - -2.13, P 0.05). Conclusion Lianhua Qingwen Capsules combined treatment for patients with community acquired pneumonia can improve the effective rate, shorten the time of symptom relief, image outcome, less adverse reactions, and has a good adjuvant effect on community acquired pneumonia. Due to the quality and quantity of the literature, the above conclusions still need to expand the sample size, select the high quality literature for further verification. 总体而言,连花清瘟胶囊联合治疗社区获得性肺炎效果佳,安全性高。鉴于临床相关研究的缺乏,本次研究纳入文献数量较少,质量一般,存在一定发表偏倚,对结果严谨性存在一定影响。后续应增加文献数量,提升文献质量,降低发表偏倚,进一步验证研究结果。
[参考文献]
[1] 马小琴,胡蓉蓉,许金菊,等.血清降钙素原与C-反应蛋白及内毒素对社区获得性肺炎诊断的研究[J].中华医院感染学杂志,2015,25(6):1230-1232.
[2] Arnold FW,Wiemken TL,Peyrani P,et al. Mortality differences among hospitalized patients with community-acquired pneumonia in three world regions:results from the community-acquired pneumonia organization (CAPO) international cohort study [J]. Respir Med,2013,107(7):1101-1111.
[3] 郑莹,李志刚,洪波,等.不同抗感染方案对社区获得性肺炎患者炎性状态影响及疗效研究[J].中华医院感染学杂志,2016,26(17):3933-3935.
[4] 方万芬,刘子龙,赵磊,等.3种用药方案治疗社区获得性肺炎的成本-效益分析[J].中华医院感染学杂志,2015, 25(16):3711-3713.
[5] 蒋岳达,吴彩芬,娄昭君,等.连花清瘟胶囊联合利巴韦林气雾剂治疗急性上呼吸道感染的效果[J].中国医药导报,2014,11(23):64-66,70.
[6] 陈轶玲.连花清瘟胶囊治疗流行性感冒的临床效果研究[J].齐齐哈尔医学院学报,2013,34(9):1304.
[7] 蔡林利,蒋红丽,樊涛,等.连花清瘟胶囊治疗流行性感冒疗效和安全性的系统评价[J].中国循证医学杂志,2012, 12(11):1396-1403.
[8] 中华医学会呼吸病学分会.社区获得性肺炎诊断和治疗指南[J].中华结核和呼吸杂志,2006,29(10):651-655.
[9] 徐清,张念,袁文胜,等.连花清瘟胶囊治疗社区获得性肺炎疗效观察[J].中国中医急症,2012,21(8):1299-1300.
[10] 王卫红.连花清瘟胶囊在100例上呼吸道感染伴肺炎患者中应用疗效观察[J].泰山医学院学报,2013,34(2):128-130.
[11] 钟小东,陈学清,吴建荣,等.连花清瘟胶囊治疗社区获得性肺炎38例观察[J].浙江中医杂志,2013,48(5):385.
[12] 姜霞,王忠平,虞??,等.连花清瘟胶囊治疗社区获得性肺炎的临床观察[J].临床合理用药杂志,2014,7(10):59-60.
[13] 李晓琳,贾芳,彭敏,等.连花清瘟胶囊联合阿奇霉素治疗社区获得性肺炎疗效观察[J].临床合理用药杂志,2014, 7(4):134-135.
[14] 朱坚,罗惠倩,盛曼斐.比较连花清瘟胶囊联合西药与单纯西药治疗肺部感染效果[J].辽宁中医杂志,2015, 42(4):797-799.
[15] 葛均波,徐永健.内科学[M].8版,北京:人民卫生出版社,2013:42.
[16] Sligl WI,Asadi L,Eurich DT,et al. Macrolides and mortality in critically ill patients with community-acquired pneumonia:a systematic review and Meta-analysis [J]. Crit Care Med,2014,42(2):420-432.
[17] Duan ZP,Jia ZH,Zhang J,et al. Natural herbal medicine Lianhuaqingwen capsule anti-influenza A (H1N1) trial:a randomized,double blind,positive controlled clinical trial [J]. Chin Med J (Engl),2011,124(18):2925-2933.
[18] Zhao P,Yang HZ,Lv HY,et al. Efficacy of Lianhuaqingwen Capsule compared with oseltamivir for influenza A virus infection:a Meta-analysis of randomized,controlled trials [J]. Altern Ther Health Med,2014, 20(2):25-30.
[19] 郭海,张庆宏,杨进,等.连花清瘟胶囊对流感病毒感染小鼠免疫功能的影响[J].南京中医药大学学报:自然科学版,2007,23(2):106-108.
[20] 姜燕,刘梦,周秀芳,等.联合连花清瘟胶囊治疗免疫功能低下患者肺部感染疗效观察[J].中国临床医生,2013, 41(12):34-36.
[21] Dong L,Xia JW,Gong Y,et al. Effect of Lianhuaqingwen Capsules on airway inflammation in patients with acute exacerbation of chronic obstructive pulmonary disease [J]. Evid Based Complement Alternat Med,2014,(2014):11.
(收稿日期:2017-06-07 本文编辑:李岳泽)