目的 基于网状Meta分析方法评价不同口服中成药辅助治疗儿童急性扁桃体炎的疗效及安全性,为儿童急性扁桃体炎的临床用药提供循证依据。方法 检索CNKI、CBM、Wanfang Data、PubMed、Cochrane Library和Embase数据库,搜集有关口服中成药辅助治疗儿童急性扁桃体炎的随机对照试验(randomized controlled trials,RCTs),检索时限为建库至2022年7月20日。采用Cochrane偏倚风险评估工具对纳入的RCTs进行质量评价,应用Stata14.0进行网状Meta分析。结果 最终纳入60篇文献,包含11种治疗措施(10种口服中成药):蒲地蓝联合抗菌药物、热速清联合抗菌药物、蓝芩口服液联合抗菌药物、金莲花联合抗菌药物、小儿青翘颗粒联合抗菌药物、芩翘口服液联合抗菌药物、双黄连口服液联合抗菌药物、小儿咽扁颗粒联合抗菌药物、小儿化毒散联合抗菌药物、疏风解毒胶囊联合抗菌药物和抗菌药物。网状Meta分析结果表明,在总有效率方面,热速清联合抗菌药物疗效最佳;在缩短退热及扁桃体脓性分泌物消失时间方面,小儿化毒散联合抗菌药物疗效最佳;在缩短咽痛时间方面,金莲花联合抗菌药物疗效最佳;在不良反应方面,各研究均未报道严重不良反应,多数研究仅报道了轻度的胃肠道反应。结论 口服中成药有助于提高抗菌药物治疗儿童急性扁桃体炎的疗效。由于纳入研究的数量及质量有差异,且中成药直接比较的研究较少,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 adjuvant treatment of children with acute tonsillitis based on network Meta-analysis, in order to provide evidence for clinical medication of children with acute tonsillitis. Methods The randomized controlled trials (RCTs) of oral Chinese patent medicine in adjuvant treatment of children with acute tonsillitis were searched from the databases of CNKI, CBM, Wanfang Data, PubMed, Cochrane Library and Embase from the establishment of each database to July 20, 2022. The quality of the included RCTs was evaluated using the Cochrane recommended risk bias assessment tool and Stata 14.0 was used for network Meta-analysis. Results Finally, 60 articles were included, including 11 kinds of treatment measures (10 kinds of oral Chinese patent medicines): Pudilan (蒲地蓝) combined with antibiotics, Resuqing (热 速清) combined with antibiotics, Lanqin Oral Liquid (蓝芩口服液) combined with antibiotics, Jinlianhua (金莲花) combined with antibiotics, Xiaoer Qingqiao Granules (小儿青翘颗粒) combined with antibiotics, Qinqiao Oral Liquid (芩翘口服液) combined with antibiotics, Shuanghuanglian Oral Liquid (双黄连口服液) combined with antibiotics, Xiaoer Yanbian Granules (小儿咽扁颗粒) combined with antibiotics, Xiaoer Huadu Powder (小儿化毒散) combined with antibiotics, Shufeng Jiedu Capsules (疏风解毒胶囊) combined with antibiotics. The results of network Meta-analysis showed that in terms of total effective rate, Resuqing combined with antibiotics was the most effective; In terms of the regression time of fever and purulent secretion, Xiaoer Huadu Powder combined with antibiotics was the most effective; In terms of the regression time of pharyngalgia, Jinlianhua combined with antibiotics was the most effective; In terms of adverse reaction events, no serious adverse reactions were reported in each study, and most studies only reported mild gastrointestinal reactions. Conclusion Oral Chinese patent medicine is helpful to improve the curative effect of antibiotics in the treatment of acute tonsillitis in children. Due to the differences in the number and the quality of the included research, and the lack of direct comparison of Chinese patent medicines, the conclusion still needs to be verified by high-quality research.

R285.64

国家科技部“十三五”重大新药创制项目“儿童中药新药临床评价技术示范性平台建设”（2020ZX09201-008）