痰熱清注射液治療社區(qū)獲得性肺炎隨機(jī)對照試驗的系統(tǒng)分析

1、文章來源 畢業(yè)論文網(wǎng) 痰熱清注射液治療社區(qū)獲得性肺炎隨機(jī)對照試驗的系統(tǒng)分析文章來源 畢業(yè)論文網(wǎng) 畢業(yè)論文 【摘要】  評價痰熱清注射液治療社區(qū)獲得性肺炎（communityacquired pneumonia, cap）的療效和安全性。方法：收集痰熱清注射液治療cap隨機(jī)對照試驗文獻(xiàn)，納入的文獻(xiàn)按不同治療策略進(jìn)行分層，jadad計分表評價納入文獻(xiàn)的質(zhì)量，對納入的試驗作系統(tǒng)評價。 結(jié)果：符合納入標(biāo)準(zhǔn)的論文共12篇。meta分析結(jié)果顯示，痰熱清與抗生素聯(lián)合治療組與抗生素治療組相比，治愈率相對危險度（relative risk, rr）為1.51，95%可信區(qū)間（confidence in

2、terval, ci）1.29，1.77；顯效率rr為1.31，95% ci 1.20，1.43；有效率rr為1.17，95% ci 1.11，1.23。退熱時間加權(quán)均數(shù)差（weighted mean difference, wmd）為1.24，95%ci 1.71，0.76；咳嗽和咳痰顯效率rr分別為1.42和1.27，95% ci 1.16，1.74和1.04，1.55；胸片陰影吸收rr為1.19，95%ci 1.09，1.30；中性粒細(xì)胞下降rr為1.10，95% ci 1.03，1.17。兩組上述各指標(biāo)比較，差異均有統(tǒng)計學(xué)意義。未報道痰熱清注射液臨床應(yīng)用相關(guān)的嚴(yán)重不良反應(yīng)。 結(jié)論：現(xiàn)有

3、臨床證據(jù)表明在抗生素及對癥治療基礎(chǔ)上給予痰熱清注射液治療cap可以明顯提高臨床療效，并明顯改善咳嗽咳痰癥狀，縮短發(fā)熱時間，促進(jìn)胸片陰影的吸收和血象恢復(fù)，未見明顯的不良反應(yīng)。由于納入研究質(zhì)量所限，尚需開展更多高質(zhì)量的研究進(jìn)一步分析。 論文網(wǎng) 畢業(yè)論文【關(guān)鍵詞】  痰熱清注射液; 社區(qū)獲得性肺炎; 隨機(jī)對照試驗; 系統(tǒng)評價; meta分析 jiang hl, mao b, zhong yq, yang hm, fu jj. j chin integr med. 2009; 7(1): 919.    received july 30, 2008;

4、accepted september 9, 2008; published online jaunary 15, 2009.    indexed/abstracted in and full text linkout at pubmed. journal title in pubmed: zhong xi yi jie he xue bao.    free full text (html and pdf) is available at .    forward linking and referen

5、ce linking via crossref.    doi: 10.3736/jcim20090102open access    tanreqing injection for communityacquired pneumonia: a systematic review of randomized evidence    hongli jiang, bing mao, yunqing zhong, hongmei yang, juanjuan fu    depar

6、tment of integrated traditional chinese and western medicine, west china hospital, sichuan university, chengdu, sichuan province 610041, china    objective: to evaluate the efficacy and safety of tanreqing injection, a compound traditional chinese herbal medicine, for communityacquire

7、d pneumonia.    methods: literatures about randomized controlled trials of tanreqing injection for communityacquired pneumonia were reviewed. related literatures were selected and analyzed according to different treatment strategies of the trials. the methodological quality of the tri

8、als was assessed by the jadad scale, and evaluation was performed.    results: twelve randomized controlled trials meeting the inclusion criteria were selected and reviewed. as tanreqing combined group (tanreqing injection plus antibiotics and basic therapy) was compared with antibiot

9、ics group (antibiotics plus basic therapy), the metaanalysis indicated that the relative risk (rr) for the total cure rate was 1.51, and 95% confidence interval (ci) was 1.29, 1.77; rr for the total obvious effect rate was 1.31, and 95% ci was 1.20，1.43; rr for the effective rate was 1.17, and 95% c

10、i was 1.11, 1.23. the weighted mean difference (wmd) in disappearance time of fever between the two groups was 1.24, and 95% ci was 1.71, 0.76. the rr values between the two groups for the total obvious effect rate of cough and expectoration were 1.42 and 1.27, and 95% cis were 1.16, 1.74 and 1.04,

11、1.55 respectively. the rr values between the two groups in absorption of chest xray shadow and neutrophil number were 1.19, 1.10 and 95% cis were 1.09, 1.30, 1.03, 1.17 respectively. the differences were all statistically significant. serious systematic adverse reactions had not been reported in the

12、 trials.    conclusion: the effect of combined therapy with tanreqing injection plus antibiotics and basic therapy is better than that of antibiotics plus basic therapy. tanreqing injection can improve the symptoms of cough and expectoration, shorten the fever time and facilitate the

13、absorption of chest xray shadow, without any significant adverse reactions. however, further highquality trials are needed.    keywords: tanreqing injection; communityacquired pneumonia; randomized controlled trials; systematic review; metaanalysis    肺炎是內(nèi)科常見病、多發(fā)病，是指終末氣道、肺泡和間質(zhì)的炎癥。按感染的場所不同，分為社區(qū)獲得性肺炎（communityacquired pneumonia, cap）和醫(yī)院獲得性肺炎。cap是指在醫(yī)院外罹患的感染性肺實質(zhì)炎癥，包括具有明確潛伏期的病原體感染而在入院后平均潛伏期內(nèi)發(fā)病的肺炎。美國每年約有300萬560萬cap患者1，超過100萬人次住院，近1 000萬人次就醫(yī)，直接醫(yī)療花費(fèi)在84億97億美元2，3。    從中醫(yī)角度來講，cap屬于中醫(yī)學(xué)風(fēng)溫肺熱、咳嗽和喘證等范疇