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[摘要]
目的 系统评价小儿豉翘清热颗粒治疗疱疹性咽峡炎的疗效和安全性,为筛选有效的口服药品提供依据。方法 检索中国学术期刊全文数据库(CNKI)、维普中文科技期刊全文数据库(VIP)、万方医学期刊全文数据库、中国生物医学文献数据库(CBM)、Pubmed、EmBase、Cochrane library等(数据库均为建库至2018年1月)关于小儿豉翘清热颗粒治疗疱疹性咽峡炎随机对照试验(RCT),筛选对照组为利巴韦林的文献,采用Cochrane风险偏倚评估工具评价纳入研究的质量,使用统计软件Revman 5.3进行Meta-分析。结果 共纳入11项RCT,共计1 384例。Meta-分析结果显示:小儿豉翘清热颗粒的总有效率明显高于利巴韦林对照组[OR=3.92,95% CI(2.72,5.67),P<0.000 01],并在体温恢复正常[MD=-1.21,95% CI(-1.27,-1.15),P<0.000 01)]、疱疹愈合[MD=-2.73,95% CI(-2.91,-2.55),P<0.000 01]、流涎停止[MD=-1.05,95% CI(-1.13,-0.98),P<0.000 01]、血常规恢复正常[MD=-2.23,95% CI(-2.47,-2.00),P<0.00001]等方面,均优于利巴韦林对照组,且差异均有统计学意义;不良反应发生率无统计学意义[OR=0.85,95% CI(0.39,1.87),P=0.69]。结论 小儿豉翘清热颗粒治疗疱疹性咽峡炎在改善症状方面优于利巴韦林,但由于纳入文献质量普遍偏低,尚需更多严谨的临床RCT论证此结论。
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[Abstract]
Objective To systematically review the efficacy and safety of Xiaoer Chiqiao Qingre Granules versus Ribavirin in the treatment of herpangina in children, and provide evidence for screening effective oral drugs. Methods CNKI, VIP Database, WanFang Database, CBM, PubMed, EmBase, and Cochrane library were retrieved online to collect randomized controlled trials about Xiaoer Chiqiao Qingre Granules in the treatment of herpangina in children with Ribavirin as the control from their inception to January, 2018. The Cochrane risk bias assessment tool was used to evaluate the quality of the study, and the Meta-analysis was carried out with the statistical software Revman 5.3. Results There were totally 1 348 patients involved in 11 RCTs. Meta-analysis results showed that the total effective rate[OR=3.92, 95% CI (2.72, 5.67), P<0.000 01], fever clearance time[MD=-1.21, 95% CI (-1.27, -1.15), P<0.000 01], herpes regression time[MD=-2.73,95% CI (-2.91, -2.55), P<0.000 01], salivation disappearance time[MD=-1.05, 95% CI (-1.13, -0.98), P<0.000 01], and blood routine returning to normal[MD=-2.23, 95% CI (-2.47,-2.00)], P<0.000 01] of Xiaoer Chiqiao Qingre Granules were significantly better than Ribavirin. There was no significant difference in the incidence of adverse reactions[OR=0.85, 95% CI (0.39, 1.87), P=0.69]. Conclusions Xiaoer Chiqiao Qingre Granules are better than Ribavirin in the treatment of herpangina in Children and have low incidence of adverse reactions. However, the quality of literature included is generally low, so more rigorous randomized controlled trials are needed to demonstrate this conclusion
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