Li Ling, Lu Fang-guo, He Qing-hu
Department of Microbiology, Hunan University of Traditional Chinese Medicine, Changsha 410208, Hunan Province, China.
Zhong Xi Yi Jie He Xue Bao. 2009 Sep;7(9):809-13. doi: 10.3736/jcim20090902.
To systematically evaluate the clinical effects of Maxing Shigan Decoction (MXSGD), a compound traditional Chinese herbal medicine, combined with Western medicine on pneumonia in children.
In this study, the relative trials published from 1994 to 2008 were searched in Chongqing Weipu Database, Chinese Journal Full-text Database, Wanfang database, Chinese Biomedical Literature Database and other electronic database by using the method of Cochrane systematic review. At the same time the information from related journals, professional data and network were hand-searched. The methodological quality of the included trials was assessed by two evaluators, and homogeneous evaluation by meta-analysis was performed. Statistical analysis of clinical data was performed by using RevMan 4.2.7 software provided by the Cochrane Collaboration.
A total of 146 reports were found, while only eight randomized controlled trials met the inclusion criteria. The methodology quality of the reports included in the study was evaluated by the Jadad scale, and the specific random method, allocation concealment, blinding and intention-to-treat analysis were not described in all of the eight trial reports. As MXSGD combined with Western medicine group (treatment group) was compared with Western medicine group (control group), the meta-analysis indicated that the odds ratio for the total effective rate was 4.06, and the 95% confidence interval was from 2.63 to 6.27. MXSGD combined with Western medicine was good at increasing the total effective rate as compared with Western medicine, and the difference was statistically significant (P<0.000 01).
MXSGD combined with Western medicine can improve clinical symptoms and increase the total effective rate of the patients with pneumonia in children. However, its clinical effects should be further identified by high quality, multicenter and randomized controlled trials with large-scale design.
系统评价中药复方麻杏石甘汤联合西药治疗小儿肺炎的临床疗效。
采用Cochrane系统评价方法，检索重庆维普数据库、中国期刊全文数据库、万方数据库、中国生物医学文献数据库等电子数据库1994年至2008年发表的相关试验。同时手工检索相关期刊、专业资料及网络信息。由两名评价者对纳入试验的方法学质量进行评价，并采用Meta分析进行同质性评价。利用Cochrane协作网提供的RevMan 4.2.7软件对临床资料进行统计分析。
共检索到146篇报道，仅8项随机对照试验符合纳入标准。采用Jadad量表对纳入研究的报道进行方法学质量评价，8篇试验报道均未描述具体随机方法、分配隐藏、盲法及意向性分析。麻杏石甘汤联合西药组（治疗组）与西药组（对照组）比较，Meta分析显示总有效率的比值比为4.06，95%可信区间为2.63至6.27。麻杏石甘汤联合西药与西药相比能提高总有效率，差异有统计学意义（P<0.000 01）。
麻杏石甘汤联合西药可改善小儿肺炎患者临床症状，提高总有效率。但其临床疗效尚需高质量、多中心、大样本随机对照试验进一步验证。
