目的 基于网状Meta分析方法评价不同口服中成药治疗儿童支气管肺炎的疗效及安全性，为儿童支气管肺炎的临床用药提供循证依据。方法 计算机检索中国知网（CNKI）、万方（Wanfang）、维普（VIP）、PubMed、Cochrane Library、Web of Science等数据库，检索有关口服中成药治疗儿童支气管肺炎的临床随机对照试验（randomized controlled trial，RCT），检索时限为各数据库建库至2021年8月4日。采用Cochrane推荐的偏倚风险评估工具对纳入的RCT进行质量评价。应用RevMan 5.4进行传统Meta分析，R软件和GeMTC进行贝叶斯模型网状Meta分析。结果 最终纳入文献106篇，均为中文文献，总样本量13 005例，其中试验组6599例，对照组6406例，涉及16种口服中成药。网状Meta分析结果表明，在临床总有效率方面，复方鱼腥草颗粒疗效最为显著，其次为小儿定喘口服液和鱼腥草合剂；在咳嗽消失时间方面，小儿咳喘灵颗粒/口服液疗效最为显著，其次为小儿肺热咳喘颗粒/口服液和肺炎合剂；在退热时间方面，金振口服液疗效最为显著，其次为复方鱼腥草颗粒和小儿咳喘灵颗粒/口服液；在肺部啰音消失时间方面，小儿咳喘灵颗粒/口服液疗效最为显著，其次为肺炎合剂和小儿消积止咳口服液。在不良反应事件方面，多数研究仅报道了轻度的胃肠道反应，各干预措施均未出现严重的不良反应事件。结论 将临床总有效率排序结果作为临床选择用药依据，由此得出复方鱼腥草颗粒、小儿定喘口服液、鱼腥草合剂、小儿咳喘灵颗粒/口服液、金振口服液5种口服中成药成为治疗儿童支气管肺炎最优方案的可能性最大。由于纳入研究方法学质量偏低，结论仍有待高质量的研究加以验证。

Objective To evaluate the efficacy and safety of different oral Chinese patent medicine in the treatment of children with bronchopneumonia based on network Meta-analysis, in order to provide evidence for clinical medication of bronchopneumonia. Methods The clinical randomized controlled trials (RCT) of oral Chinese patent medicine in the treatment of children with bronchopneumonia were searched from the databases of CNKI, Wanfang, VIP, PubMed, Cochrane Library, and Web of Science from the establishment of each database to August 4, 2021. The quality of the included RCTs was evaluated using the Cochrane recommended bias risk assessment tool. RevMan 5.4 was used for pairwise Meta-analysis, R project and GeMTC were used for network Meta-analysis. Results A total of 106 RCTs were included, all of which were Chinese, with a total sample size of 13 005 cases, including 6599 cases in the experimental group and 6406 cases in the control group, involving 16 oral Chinese patent medicines. The results of network Meta-analysis showed that in terms of clinical total effective rate, Compound Houttuynia Granule (复方鱼腥草颗粒) was the most effective, followed by Xiaoer Dingchuan Oral Liquid (小儿定喘口服液) and Houttuynia Mixture (鱼腥草合剂); In terms of cough disappearance time, Xiaoer Kechuanling Granule/Oral Liquid (小儿咳喘灵颗粒/口服液) was the most effective, followed by Xiaoer Feire Kechuanling Granule/Oral Liquid (小儿肺热咳喘颗粒/口服液) and Pneumonia Mixture (肺炎合剂); In terms of fever disappearance time, Jinzhen Oral Liquid (金振口服液) was the most effective, followed by Compound Houttuynia Granule and Xiaoer Kechuanling Granule/Oral Liquid; In terms of the disappearance time of lung rale, the curative effect of Xiaoer Kechuanling Granule/Oral Liquid was the most significant, followed by Pneumonia Mixture and Xiaoer Xiaoji Zhike Oral Liquid (小儿消积止咳口服液). In terms of adverse reaction events, most studies only reported mild gastrointestinal reactions, and no serious adverse reaction events occurred in various intervention measures. Conclusion Taking the ranking results of clinical total effective rate as the basis for clinical drug selection, it is concluded that five oral Chinese patent medicines such as Compound Houttuynia granule, Xiaoer Dingchuan Oral Liquid, Houttuynia Mixture, Xiaoer Kechuanling Granule/Oral Liquid and Jinzhen Oral Liquid are the most likely to be the best scheme for the treatment of children’s bronchopneumonia. Due to the low quality of the included research methodology, the conclusion still needs to be verified by high-quality research.

R285.64

天津市中医药重点领域科技项目：中医药防治新冠肺炎证据库建立与循证评价研究（2021002）