摘要
目的:评价中药方剂内服治疗耐药细菌性肺炎的临床疗效及安全性。方法:计算机检索国内外常用数据库共8个,由2名研究者独立筛选文献、提取资料,并对纳入研究的文献进行方法学质量评价后,采用RevMan 5.3软件对结局指标进行Meta分析。结果:共纳入24项研究,涉及病例1 818例。Meta分析结果显示,中药方剂内服联合西医常规疗法组在总有效率[相对危险度(RR)=1.27,95%置信区间(CI)(1.21,1.34),P<0.000 01],耐药菌清除率[RR=1.49,95%CI(1.33,1.66),P<0.000 01],临床肺部感染评分(CPIS)变化[均数差(MD)=-1.64,95%CI(-1.87,-1.41),P<0.000 01]方面均优于单纯西医常规治疗组,在不良反应发生率方面两者差异无统计学意义[RR=0.72,95%CI(0.48,1.07),P=0.1]。此外,与单纯西医常规治疗相比,中药方剂内服干预在总有效率,CPIS变化方面也有一定优势。结论:从目前的研究结果来看,中药方剂内服或联合西医常规疗法比单纯西医常规方法治疗耐药细菌性肺炎有更好的临床疗效,且不会增加不良事件发生率。受纳入研究数量和质量限制,上述结论尚待更多高质量研究予以验证。
Objective: To evaluate the efficacy and safety of Chinese medicinal formulae in the treatment of antimicrobial-resistant pneumonia. Method: Following article retrieval from eight databases and data extraction by two reviewers,the methodological quality of the included trials was assessed and the outcome indicators were subjected to Meta-analysis using RevMan 5.3. Result:A total of 24 randomized controlled trials(RCTs)were included,involving 1 818 cases. Meta-analysis showed that Chinese medicinal formulae combined with western routine intervention was superior to the western routine intervention in improving the overall response rate(ORR)[relative risk(RR)=1.27,95% confidence interval(CI)(1.21,1.34),P<0.000 01],the bacterial clearance rate[RR=1.49,95% CI(1.33,1.66),P<0.000 01],and the clinical pulmonary infection score(CPIS)[mean difference(MD)=-1.64,95% CI(-1.87,-1.41),P<0.000 01]. There was no significant difference in the incidence of adverse reactions[RR=0.72,95% CI(0.48,1.07),P=0.1]. The comparison with the western routine intervention also revealed that Chinese medicinal formulae better improved the ORR and CPIS. Conclusion: According to the current research results, the Chinese medicinal formulae alone or combined with western routine intervention yielded more favorable clinical outcomes than western routine intervention in the treatment of antimicrobial-resistant pneumonia,without increasing the incidence of adverse events. Due to limited quality and quantity of the included RCTs,more high-quality trials are required to verify the above conclusions.
作者
贾丽阳
邓冬
屈瑶
孙丽华
卜建宏
陈振翼
叶苗青
方邦江
JIA Li-yang;DENG Dong;QU Yao;SUN Li-hua;BU Jian-hong;CHEN Zhen-yi;YE Miao-qing;FANG Bang-jiang(Longhua Hospital,Shanghai University of Traditional Chinese Medicine(TCM),Shanghai 200032,China;Shanghai Municipal Hospital of TCM,Shanghai 200071,China;Henan Province Hospital of TCM,Zhengzhou 450002,China;A.Shanxi Province Hospital of TCM,Xi'an 710000,China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2021年第11期205-212,共8页
Chinese Journal of Experimental Traditional Medical Formulae
基金
国家重点研发计划项目(2018YFC1705900)
国家自然科学基金面上项目(81973811)
上海市科学技术委员会科研计划项目(18401971600,19401933300)
上海市重点专科建设项目(shslczdzk04401)。
关键词
中药方剂
耐药细菌性肺炎
系统评价
META分析
随机对照试验
Chinese medicinal formulae
antimicrobial-resistant pneumonia
systematic review
Meta-analysis
randomized controlled trials(RCTs)
