Meremikwu M, Oyo-Ita A
Department of Paediatrics, University of Calabar, PMB 1115, Calabar, Cross River State, Nigeria.
Cochrane Database Syst Rev. 2003;2003(2):CD004264. doi: 10.1002/14651858.CD004264.
Health workers recommend bathing, sponging and other physical methods to treat fever in children and to avoid febrile convulsions. We know little about the most effective methods, or how these methods compare with commonly used drugs.
To evaluate the benefits and harms of physical cooling methods used for managing fever in children.
We searched the Cochrane Infectious Diseases Group specialized trials register (February 2003), the Cochrane Central Register of Controlled Trials (Issue 1, 2003), MEDLINE (1966 to February 2003), EMBASE (1988 to November 2002), CINHAL (1982 to February 2003), LILACS (February 2003), Science Citation Index (1981 to February 2003), and reference lists of articles. We also contacted researchers in the field.
Randomized and quasi-randomized trials comparing physical methods with a drug placebo or no treatment in children with fever of presumed infectious origin. Studies where children in both groups were given an antipyretic drug were included.
Two reviewers independently assessed trial methodological quality. One reviewer extracted data and the other checked the data for accuracy. Results were expressed as Relative Risk (RR) with 95% confidence intervals (CI) for discrete variables, and weighted mean differences for continuous outcomes.
Seven trials, involving 467 participants, met the inclusion criteria. One small trial (n = 30), comparing physical methods with drug placebo, did not demonstrate a difference in the proportion of children without fever by one hour after treatment in a comparison between physical methods alone and drug placebo. In 2 studies, where all children received an anti-pyretic drug, physical methods resulted in a higher proportion of children without fever at one hour (n=125, RR 11.8, CI 3.39 to 40.8). I; in a third study (n=130), which only reported mean change in temperature, no differences wereas detected. Mild adverse events (shivering and goose pimples) were more common in the physical methods group (3 trials, RR 5.09; CI 1.56 to 16.60).
REVIEWER'S CONCLUSIONS: A few small studies demonstrate that tepid sponging helps to reduce fever in children.
卫生工作者推荐采用洗澡、擦身及其他物理方法来治疗儿童发热并预防高热惊厥。我们对最有效的方法知之甚少，也不清楚这些方法与常用药物相比效果如何。
评估用于处理儿童发热的物理降温方法的利弊。
我们检索了Cochrane传染病学组专业试验注册库（2003年2月）、Cochrane对照试验中心注册库（2003年第1期）、MEDLINE（1966年至2003年2月）、EMBASE（1988年至2002年11月）、CINHAL（1982年至2003年2月）、LILACS（2003年2月）、科学引文索引（1981年至2003年2月）以及文章的参考文献列表。我们还联系了该领域的研究人员。
比较物理方法与药物安慰剂或不治疗对疑似感染性发热儿童影响的随机和半随机试验。两组儿童均接受退烧药治疗的研究也纳入其中。
两名评价员独立评估试验方法学质量。一名评价员提取数据，另一名评价员检查数据准确性。结果以相对危险度（RR）及95%可信区间（CI）表示离散变量，以加权均数差表示连续变量的结果。
七项试验，涉及467名参与者，符合纳入标准。一项小型试验（n = 30）比较了物理方法与药物安慰剂，在单独物理方法与药物安慰剂的比较中，未显示治疗一小时后无发热儿童比例存在差异。在两项研究中，所有儿童均接受退烧药治疗，物理方法导致一小时时无发热儿童比例更高（n = 125，RR 11.8，CI 3.39至40.8）。在第三项研究（n = 130）中，仅报告了体温的平均变化，未检测到差异。物理方法组中轻微不良事件（寒战和鸡皮疙瘩）更为常见（3项试验，RR 5.09；CI 1.56至16.60）。
一些小型研究表明，温水擦浴有助于降低儿童体温。
