摘要
目的:评价中西医结合治疗重症肺炎的疗效及安全性。方法:系统检索CNKI、WANFANG DATA、VIP、SinoMed、EMbase、PubMed、The Cochrane Library,按照预先设定纳入与排除标准筛选随机对照临床试验,应用风险评估工具进行研究质量评价,提取数据并运用Revman 5. 3软件进行Meta分析。共检索到741篇文献,最终纳入17个研究,总样本数为1261例,试验组642例和对照组619例。结果:中西医结合治疗重症肺炎与单用西医治疗相比,能有效降低病死率[RR=0. 45,95%CI(0. 30,0. 68),P=0. 00001];提高总有效率[RR=1. 21,95%CI(1. 11,1. 32),P <0. 00001]、减少住院天数[MD=-2. 7,95%CI(-4. 18,-1. 21),P=0. 0003];缩短机械通气时间[SMD=-1. 33,95%CI(-2. 43,-0. 22),P≤0. 00001]。不良反应较轻微,主要以胃肠道反应和头疼为主。结论:中西医结合治疗重症肺炎,疗效优于单用西医治疗。但由于纳入研究质量偏低,研究结论仍有待更多高质量随机对照试验以验证。
Objective: The paper is to systematically evaluate the effect and safety of integrated traditional and western medicine for severe pneumonia. Methods: Randomized controlled trials( RCTs) were electronically retrieved from CNKI,Wanfang Data,VIP,Sino Med,EMbase,Pubmed and Cochrane Library according to the preset inclusion criteria and exclusion criteria. Then risk assessment tools were used for quality evaluation of the studies,and data extraction and analysis were conducted by Rev Man 5. 3 software for Meta-analysis. A total of 741 articles were retrieved,and finally 17 studies were included. The total sample number was 1261,including 642 cases in experimental group and 619 cases in control group. Results: Compared with conventional medicine,integrated traditional and western medicine reduced the mortality[RR = 0. 45,95% CI( 0. 30,0. 68),P = 0. 00001],had better efficiency[RR = 1. 21,95% CI( 1. 11,1. 32),P < 0. 00001],reduced duration of hospital stay[MD =-2. 7,95% CI(-4. 18,-1. 21),P = 0. 0003] and duration of mechanical ventilation [SMD =-1. 33,95% CI(-2. 43,-0. 22),P ≤0.00001]. The main adverse reactions reported were gastrointestinal symptoms and headache. Conclusion: Integrated traditional and western medicine showed better efficacy than conventional medicine in treatment of severe pneumonia. However,because of low-quality in the included studies,more high-quality randomized controlled trials would be needed in the future.
引文
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