穴位敷贴治疗小儿反复呼吸道感染的Meta分析
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摘要
目的通过对穴位敷贴治疗小儿反复呼吸道感染的临床疗效进行系统评价,寻找循证医学证据,进一步验证穴位敷贴治疗小儿反复呼吸道感染的临床效价,指导临床实践。方法按照系统评价要求,计算机检索中国期刊全文数据库(CNKI)、万方期刊数据库、维普中文期刊数据库(VIP)、中国生物医学文献数据库(CBM)、PubMed、The Cochrane Library、Google Scholar关于穴位敷贴治疗小儿反复呼吸道感染的临床随机对照试验文献。检索时限从1995年1月～2018年3月。所得文献由2位研究者根据纳入与排除标准独立筛选、提取和质量评价,符合要求的文献采用Cochrane协作网提供的Review Manage 5.0软件进行统计分析。结果最终纳入文献18篇,经Meta分析合并后结果显示:优势比(OR)为5.93,95%置信区间(CI):4.66～7.55;18项研究同质性检验结果,自由度为17(P=0.02)。故采用固定效应模型进行分析统计计算、汇总统计量,OR合并后经Z检验,Z=14.45(P<0.01)。穴位敷贴治疗小儿反复呼吸道感染的临床疗效优于对照组,差异具有统计学意义(P<0.01)。结论穴位敷贴治疗小儿反复呼吸道感染的临床疗效确切,优于口服药物、空白模拟等疗法。受纳入研究文献质量、数量所限,尚需更多设计合理、科学规范的高质量临床随机对照试验进一步验证其临床疗效。
Objective To systematically evaluate the clinical efficacy of acupoint application in the treatment of children with recurrent respiratory tract infection, and to find evidence-based medical evidence to further verify the clinical cost of acupoint application in the treatment of children with recurrent respiratory tract infection and to guide clinical practice. Methods According to the requirements of systematic evaluation, computer search Chinese Journal Full-text Database(CNKI), Wanfang Journal Database, Weipu Chinese Journal Database(VIP), China Biomedical Literature Database(CBM), PubMed, The Cochrane Library, Google Scholar on acupoint application A clinical randomized controlled trial of children with repeated respiratory infections. The search time limit is from January 1995 to March 2018. The obtained literature was independently screened, extracted and evaluated by two investigators according to the inclusion and exclusion criteria. The compliant documents were statistically analyzed using Review Manage 5.0 software provided by the Cochrane Collaboration. Results Finally, 18 articles were included in the literature. The results of the metaanalysis showed that the odds ratio(OR) was 5.93, the 95% confidence interval(CI) was 4.66 to 7.55, and the homogeneity test results of 18 studies were 17(P = 0.02). Therefore, the fixed effect model was used to analyze the statistical calculations and summarize the statistics. After the OR combination, the Z test was performed, Z=14.45(P<0.01). The clinical effect of acupoint application on children with repeated respiratory infection was better than that of the control group,the difference was statistically significant(P<0.01). Conclusion The clinical efficacy of acupoint application in the treatment of children with repeated respiratory tract infection is better than oral medication and blank simulation. Due to the limited quality and quantity of the research literature, more high-quality clinical randomized controlled trials with reasonable design and scientific specifications are needed to further verify the clinical efficacy.
Objective To systematically evaluate the clinical efficacy of acupoint application in the treatment of children with recurrent respiratory tract infection, and to find evidence-based medical evidence to further verify the clinical cost of acupoint application in the treatment of children with recurrent respiratory tract infection and to guide clinical practice. Methods According to the requirements of systematic evaluation, computer search Chinese Journal Full-text Database(CNKI), Wanfang Journal Database, Weipu Chinese Journal Database(VIP), China Biomedical Literature Database(CBM), PubMed, The Cochrane Library, Google Scholar on acupoint application A clinical randomized controlled trial of children with repeated respiratory infections. The search time limit is from January 1995 to March 2018. The obtained literature was independently screened, extracted and evaluated by two investigators according to the inclusion and exclusion criteria. The compliant documents were statistically analyzed using Review Manage 5.0 software provided by the Cochrane Collaboration. Results Finally, 18 articles were included in the literature. The results of the metaanalysis showed that the odds ratio(OR) was 5.93, the 95% confidence interval(CI) was 4.66 to 7.55, and the homogeneity test results of 18 studies were 17(P = 0.02). Therefore, the fixed effect model was used to analyze the statistical calculations and summarize the statistics. After the OR combination, the Z test was performed, Z=14.45(P<0.01). The clinical effect of acupoint application on children with repeated respiratory infection was better than that of the control group,the difference was statistically significant(P<0.01). Conclusion The clinical efficacy of acupoint application in the treatment of children with repeated respiratory tract infection is better than oral medication and blank simulation. Due to the limited quality and quantity of the research literature, more high-quality clinical randomized controlled trials with reasonable design and scientific specifications are needed to further verify the clinical efficacy.
引文
[1]赵芸鹤,崔霞,王静.儿童反复呼吸道感染的外治法研究概述[J].现代中医临床,2018(1):56-60.
[2]宋辰斐,薛征.小儿反复呼吸道感染体质分型和辨体依据的文献研究[J].上海中医药大学学报,2018,32(1):11-14.
[3]霍莉莉,宣小平,虞坚尔,等.伏九敷贴防治反复呼吸道感染3年疗效趋势分析[J].新中医,2014,46(2):183-186.
[4]张润翯,林立,林莹.中药穴位敷贴治疗小儿反复呼吸道感染的meta分析[J].医药,2015(1):167-169.
[5]刘丽平,杨明,张岩,等.穴位敷贴对小儿反复呼吸道感染的治疗作用及对T细胞亚群的影响[J].中国妇幼保健,2015,30(20):3411-3412.
[6]刘红玲.三伏药贴治疗小儿反复呼吸道感染159例疗效观察[J].右江医学,2009,37(6):718-719.
[7]孙斌,陆卫娟.咳喘膏防治小儿反复呼吸道感染150例临床观察[J].中医药导报,2007,13(12):34-35.
[8]李媛媛.中药辨证穴位敷贴治疗小儿反复呼吸道感染[J].大家健康,2017,12(11).
[9]李小艳.三黄屏风膏穴位敷贴防治小儿反复呼吸道感染临床观察[J].中医临床研究,2013(15):38-39.
[10]林慈升.三伏贴防治小儿反复呼吸道感染可行性分析[J].实用中西医结合临床,2016,16(11):65-66.
[11]沈增晖,郑飞平.冬病夏治穴位敷贴法治疗小儿反复呼吸道感染49例临床观察[J].中医儿科杂志,2016,12(6):42-44.
[12]王伟.冬病夏治穴位敷贴治疗小儿反复呼吸道感染42例疗效观察[J].中国中西医结合儿科学,2012,4(6):559-561.
[13]王利然.传统穴位加神阙穴贴敷治疗小儿反复呼吸道感染126例疗效观察[J].中国中西医结合儿科学,2009,1(4):349-350.
[14]秦文,林秋芳,裘红玲,等.穴位敷贴防治小儿反复呼吸道感染53例临床研究[J].江苏中医药,2010,42(12):19-20.
[15]葛芳,徐国平,马秀格,等.中药穴位敷贴治疗小儿反复呼吸道感染疗效观察[J].医学理论与实践,2010,23(12).
[16]蔡建新,陈华,陈建华,等.咳喘三伏贴防治小儿反复呼吸道感染疗效分析[J].光明中医,2011,26(5):985-987.
[17]路桂华.自拟消咳贴穴位敷贴治疗小儿反复呼吸道感染的临床研究[J].护理研究,2004,18(13):1133-1135.
[18]邓玉萍.中药穴位敷贴防治小儿反复呼吸道感染60例[J].湖北中医杂志,2008,30(1):38-39.
[19]郑妙玲,罗桂平.冬病夏治定喘止咳贴治疗小儿反复呼吸道感染肺脾两虚型疗效观察[J].实用中医药杂志,2017,33(10):1208-1209.
[20]郝大燕.冬病夏治穴位敷贴治疗儿童反复呼吸道感染的效果观察[J].当代护士,2016(5):76-77.
[21]陆建中.中药辨证穴位敷贴治疗小儿反复呼吸道感染[J].当代医学,2015,21(7):144-145.
[22]马喜凤,姜炫合.冬病夏治穴位贴敷咳喘贴防治小儿反复呼吸道感染45例临床观察[J].中医儿科杂志,2017(5):37-39.
[23]朱宝,宋瑞平,张彦军.中药穴位贴敷疗法的理论与机制探讨[J].甘肃医药,2016,35(8):578-580.
[24]莫珊,黎家楼,黄卓红,等.培土生金穴位敷贴治疗对儿童咳嗽变异型哮喘的临床症状及IgE的影响[J].时珍国医国药.2018,29(04),907-909.
[2]宋辰斐,薛征.小儿反复呼吸道感染体质分型和辨体依据的文献研究[J].上海中医药大学学报,2018,32(1):11-14.
[3]霍莉莉,宣小平,虞坚尔,等.伏九敷贴防治反复呼吸道感染3年疗效趋势分析[J].新中医,2014,46(2):183-186.
[4]张润翯,林立,林莹.中药穴位敷贴治疗小儿反复呼吸道感染的meta分析[J].医药,2015(1):167-169.
[5]刘丽平,杨明,张岩,等.穴位敷贴对小儿反复呼吸道感染的治疗作用及对T细胞亚群的影响[J].中国妇幼保健,2015,30(20):3411-3412.
[6]刘红玲.三伏药贴治疗小儿反复呼吸道感染159例疗效观察[J].右江医学,2009,37(6):718-719.
[7]孙斌,陆卫娟.咳喘膏防治小儿反复呼吸道感染150例临床观察[J].中医药导报,2007,13(12):34-35.
[8]李媛媛.中药辨证穴位敷贴治疗小儿反复呼吸道感染[J].大家健康,2017,12(11).
[9]李小艳.三黄屏风膏穴位敷贴防治小儿反复呼吸道感染临床观察[J].中医临床研究,2013(15):38-39.
[10]林慈升.三伏贴防治小儿反复呼吸道感染可行性分析[J].实用中西医结合临床,2016,16(11):65-66.
[11]沈增晖,郑飞平.冬病夏治穴位敷贴法治疗小儿反复呼吸道感染49例临床观察[J].中医儿科杂志,2016,12(6):42-44.
[12]王伟.冬病夏治穴位敷贴治疗小儿反复呼吸道感染42例疗效观察[J].中国中西医结合儿科学,2012,4(6):559-561.
[13]王利然.传统穴位加神阙穴贴敷治疗小儿反复呼吸道感染126例疗效观察[J].中国中西医结合儿科学,2009,1(4):349-350.
[14]秦文,林秋芳,裘红玲,等.穴位敷贴防治小儿反复呼吸道感染53例临床研究[J].江苏中医药,2010,42(12):19-20.
[15]葛芳,徐国平,马秀格,等.中药穴位敷贴治疗小儿反复呼吸道感染疗效观察[J].医学理论与实践,2010,23(12).
[16]蔡建新,陈华,陈建华,等.咳喘三伏贴防治小儿反复呼吸道感染疗效分析[J].光明中医,2011,26(5):985-987.
[17]路桂华.自拟消咳贴穴位敷贴治疗小儿反复呼吸道感染的临床研究[J].护理研究,2004,18(13):1133-1135.
[18]邓玉萍.中药穴位敷贴防治小儿反复呼吸道感染60例[J].湖北中医杂志,2008,30(1):38-39.
[19]郑妙玲,罗桂平.冬病夏治定喘止咳贴治疗小儿反复呼吸道感染肺脾两虚型疗效观察[J].实用中医药杂志,2017,33(10):1208-1209.
[20]郝大燕.冬病夏治穴位敷贴治疗儿童反复呼吸道感染的效果观察[J].当代护士,2016(5):76-77.
[21]陆建中.中药辨证穴位敷贴治疗小儿反复呼吸道感染[J].当代医学,2015,21(7):144-145.
[22]马喜凤,姜炫合.冬病夏治穴位贴敷咳喘贴防治小儿反复呼吸道感染45例临床观察[J].中医儿科杂志,2017(5):37-39.
[23]朱宝,宋瑞平,张彦军.中药穴位贴敷疗法的理论与机制探讨[J].甘肃医药,2016,35(8):578-580.
[24]莫珊,黎家楼,黄卓红,等.培土生金穴位敷贴治疗对儿童咳嗽变异型哮喘的临床症状及IgE的影响[J].时珍国医国药.2018,29(04),907-909.