利巴韦林单用与联用小儿柴桂退热颗粒治疗小儿急性上呼吸道感染的临床疗效及其安全性Meta分析

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英文篇名：Clinical efficacy and safety of ribavirin used alone or combined with Xiaoer Chaigui Tuire granules( 小儿柴桂退热颗粒 ) in treatment of acute upper respiratory tract infection in children: a Meta analysis 作者：陈兴 ; 于洋 ; 李素那 ; 贠启龙 ; 吴博 ; 钱丽旗 英文作者：Chen Xing;Yu Yang;Li Su'na;Yun Qilong;Wu Bo;Qian Liqi;College of Pharmacy, Chengdu University of Traditional Chinese Medicine;Department of Traditional Chinese Medicine, First Affiliated Hospital of Chinese PLA General Hospital; 关键词：小儿柴桂退热颗粒 ; 利巴韦林 ; 小儿上呼吸道感染 ; 临床疗效 ; Meta分析 英文关键词：XiaoEr ChaiGui TuiRe granule;;Ribavirin;;Acute Upper Respiratory Tract Infection in Children;;Meta Analysis 中文刊名：GRYX 英文刊名：Infection,Inflammation,Repair 机构：成都中医药大学药学院;解放军总医院第一附属医院中医科; 出版日期：2018-06-20 出版单位：感染、炎症、修复 年：2018 期：v.19 基金：中国医药教育协会孙思邈中医药研究专项课题(2016SKT-M035) 语种：中文; 页：GRYX201802005 页数：11 CN：02 ISSN：11-5225/R 分类号：10-20

摘要

目的:比较利巴韦林单用及与小儿柴桂退热颗粒联用治疗小儿急性上呼吸道感染的临床疗效及其安全性。方法 :在中国知网(CNKI)、中国生物医学文献数据库(CBM)、万方数据库(Wanfang)和维普中文科技期刊全文数据库(VIP)、PubMed中,以"小儿柴桂退热颗粒""利巴韦林""小儿急性上呼吸道感染"为关键词,检索小儿柴桂退热颗粒单用及联用利巴韦林治疗小儿急性上呼吸道感染的临床随机对照试验(RCT)研究报道,筛选出符合纳入标准的文献,提取基线信息并进行质量评估,并以RevMan 5.3软件为工具,对研究数据进行统计学分析。结果:本研究共纳入14篇RCT研究,合计2 171例患儿。Meta分析研究结果显示,与单用利巴韦林治疗小儿上呼吸道感染组相比,单用小儿柴桂退热颗粒组除了可显著缩短患儿咽部红肿消退时间[MD=-0.15,95%CI (-0.24,-0.06),P=0.002]及减少不良反应发生率[MD=0.12,95%CI (0.02,0.68),P=0.02]外,其他疗效指标未能明显优于单用利巴韦林;而小儿柴桂退热颗粒联用利巴韦林组能显著提高临床总有效率[OR=5.43,95%CI (3.23,9,12),P<0.00001],显著缩短患儿的退热时间[MD=-0.53,95%CI (-0.72,-0.35),P<0.00001]、止涕时间[MD=-0.90,95%CI (-1.22,-0.57),P<0.000 01]、咽部红肿时间[MD=-0.38,95%CI (-0.62,-0.14),P=0.002]、治愈时间[MD=-0.80,95%CI (-1.22,-0.38),P=0.000 2]及不良反应发生率[MD=0.34,95%CI (0.12,0.97),P=0.04],还可显著降低患儿体内C-反应蛋白(CRP)含量[MD=-6.58,95%CI (-9.23,-3.94),P<0.00001],从而有效缓解小儿急性上呼吸道感染病情。结论 :小儿柴桂退热颗粒联用利巴韦林治疗小儿急性上呼吸道感染的临床疗效及药物安全性明显优于单用利巴韦林。
        Objective: To investigate and compare the clinical efficacy and safety of Xiaoer Chaigui Tuire granules(XCGTRg, 小儿柴桂退热颗粒) used alone or combined with ribavirin in treatment of acute upper respiratory tract infection in children. Methods: By searching the database of CNKI, CBM, Wanfang, VIP and PubMed, "Xiaoer Chaigui Tuire granules", "ribavirin" and "acute upper respiratory tract infection in children" were used as the key words to retrieve the articles dealt with the clinical randomly controlled trials(RCTs) of acute upper respiratory infection in children treated with XCGTRg alone or combined with ribavirin, and to screen out the references that meet the inclusion criteria. The evaluators made data extraction and quality assessment of the included articles, and made a statistical analysis with software RevMan5.3. Results: A total of 14 RCTs with 2171 participants were included in present study. Meta-analysis showed that, compared with using ribavirin alone, XCGTRg used alone may significantly shorten the time of children pharyngeal swelling [MD=-0.15, 95% CI(-0.24,-0.06), P=0.002] and reduce the incidence of adverse reactions [MD= 0.12, 95% CI(0.02, 0.68), P=0.02], while the other efficacy indicators showed no significant difference. However, application of XCGTRg combined with Ribavirin may significantly improve the total clinical efficiency [OR=5.43, 95% CI(3.23, 9.12), P <0.00001], remarkably shorten the children antipyretic time [MD=-0.53, 95% CI(-0.72,-0.35), P<0.00001], runny nose time [MD=-0.90, 95% CI(-1.22,-0.57), P<0.00001], pharyngeal swelling time [MD=-0.38, 95% CI(-0.62,-0.14), P=0.002], recovery time[MD=-0.80, 95% CI(-1.22,-0.38), P=0.0002], and lower the incidence of adverse reactions [MD= 0.34, 95% CI(0.12, 0.97), P=0.04]. It can also significantly decrease the C-reactive protein(CRP) levels in children [MD=-6.58, 95% CI(-9.23,-3.94), P<0.00001], thereby effectively relieves the symptoms of acute upper respiratory tract infection in children. Conclusions: The clinical efficacy and drug safety of XCGTRg combined with ribavirin for children with acute upper respiratory tract infection is much better than that of ribavirin alone. The therapeutic regimen is worthy of popularization and application.

引文

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