发热儿童使用解热药是否会延长发热病程？系统评价和荟萃分析。
Does the use of antipyretics in children who have acute infections prolong febrile illness? A systematic review and meta-analysis.
机构信息
King's College London, London, United Kingdom.
出版信息
J Pediatr. 2013 Sep;163(3):822-7.e1-2. doi: 10.1016/j.jpeds.2013.03.069. Epub 2013 May 8.
OBJECTIVE
To review the literature and test the hypothesis that the use of antipyretic drugs in children with acute infections slows recovery.
STUDY DESIGN
A systematic review and meta-analysis of the literature was undertaken to investigate the effect of antipyretic drugs upon recovery from infectious diseases in children. A search of Medline (1946 until November 2012) and EMBASE (1980 until November 1, 2012) was undertaken to identify studies in which the authors compared the use of antipyretic medications with nonpharmacologic treatments for fever.
RESULTS
Six papers were identified, 5 of which were included in the meta-analysis. Three studies focused on children with malaria and the other 3 considered general viral and respiratory infections and varicella. The pooled mean difference in time to fever clearance was 4.16 hours and was faster in those receiving antipyretics compared with those not (95% CI -6.35 to -1.96 hours; P = .0002). There was little evidence of statistical heterogeneity (χ(2) 4.84; 4 df; P = .3; I(2) 17%).
CONCLUSION
There is no evidence from these studies that the use of antipyretics slows the resolution of fever in children.
目的
回顾文献并验证假说，即急性感染儿童使用退热药物会减缓康复速度。
研究设计
系统地回顾和分析文献，以调查退热药物对儿童传染病康复的影响。检索 Medline（1946 年至 2012 年 11 月）和 EMBASE（1980 年至 2012 年 11 月 1 日），以确定作者比较退热药物与非药物治疗发热的研究。
结果
确定了 6 篇论文，其中 5 篇纳入荟萃分析。3 项研究集中在疟疾儿童，另外 3 项考虑了一般病毒和呼吸道感染以及水痘。接受退热药物治疗的患者与未接受治疗的患者相比，退热时间的平均差异为 4.16 小时，退热更快（95%CI-6.35 至-1.96 小时；P =.0002）。几乎没有统计学异质性的证据（χ(2)4.84；4 个自由度；P =.3；I(2)17%）。
结论
这些研究没有证据表明退热药物会减缓儿童发热的消退。
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