Gao Li-Ni, Lyu Jian, Wang Zhi-Fei, Yu Dan-Dan, Sun Meng-Hua
Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences Beijing 100700,China Wangjing Hospital,China Academy of Chinese Medical Sciences Beijing 100102,China.
Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences Beijing 100700,China.
Zhongguo Zhong Yao Za Zhi. 2019 Dec;44(24):5313-5321. doi: 10.19540/j.cnki.cjcmm.20190924.501.
To systematically review the effectiveness and safety of Tanreqing Injection in treating acute exacerbation of chronic bronchitis( AECB). CNKI,Wan Fang,VIP,CBM,Medline,Cochrane Library,EMbase and Web of Science were retrieved,and randomized controlled trials for the effect of Tanreqing Injection in the treatment of acute exacerbation of chronic bronchitis were screened. The quality of the included studies was evaluated according to the Cochrane Handbook's evaluation criteria. The data was analyzed by RevMan 5.3. Totally 23 RCTs involving 1 901 patients were included,including 952 in the experimental group and 949 in the control group. The Meta-analysis demonstrated that in terms of the disappearance time of fever,the group of Tanreqing Injection combined with the conventional therapy was superior to conventional therapy group( RR =-1. 03,95%CI[-1. 45,-0. 62],P<0. 000 01); compared with the conventional therapy group,the group of Tanreqing Injection combined with conventional therapy had a higher cure rate for AECB( RR = 1. 17,95% CI[1. 13,1. 23],P < 0. 000 01). The group of Tanreqing Injection combined with levofloxacin had a higher cure rate for AECB than the levofloxacin group( RR = 1. 23,95% CI[1. 08,1. 41],P = 0. 002). The group of Tanreqing Injection combined with cefuroxime had a higher cure rate for AECB than the cefuroxime group( RR = 1. 22,95%CI[1. 05,1. 42],P = 0. 01).The group of Tanreqing Injection combined with cefoperazone sodium and sulbactam sodium had a higher cure rate for AECB than the group of cefoperazone sodium and sulbactam sodium( RR = 1. 22,95% CI[1. 04,1. 44],P = 0. 02). The outcomes of disappearance time of cough and expectoration had a huge heterogeneity,so were used for descriptive analysis. The adverse reactions mainly included skin rash,dizziness,gastrointestinal reactions. Based on the available data and the results of the analysis,the group of Tanreqing Injection combined with Western medicine has a higher cure rate for acute exacerbation of chronic bronchitis,and the effect in reducing symptoms disappearance time. In view of the limited number of included studies,small sample size and low methodological quality,the results of this study need to be confirmed with high-level clinical trials.
系统评价痰热清注射液治疗慢性支气管炎急性加重期（AECB）的有效性和安全性。检索中国知网、万方、维普、中国生物医学文献数据库、Medline、Cochrane图书馆、EMbase及Web of Science，筛选痰热清注射液治疗慢性支气管炎急性加重期疗效的随机对照试验。根据Cochrane手册评价标准对纳入研究的质量进行评价。采用RevMan 5.3软件进行数据分析。共纳入23项随机对照试验，涉及1901例患者，其中试验组952例，对照组949例。Meta分析结果显示，在退热时间方面，痰热清注射液联合常规治疗组优于常规治疗组（RR=-1.03，95%CI[-1.45，-0.62]，P<0.000 01）；与常规治疗组比较，痰热清注射液联合常规治疗组对AECB的治愈率更高（RR=1.17，95%CI[1.13，1.23]，P<0.000 01）。痰热清注射液联合左氧氟沙星组对AECB的治愈率高于左氧氟沙星组（RR=1.23，95%CI[1.08，1.41]，P=0.002）。痰热清注射液联合头孢呋辛组对AECB的治愈率高于头孢呋辛组（RR=1.22，95%CI[1.05，1.42]，P=0.01）。痰热清注射液联合头孢哌酮钠舒巴坦钠组对AECB的治愈率高于头孢哌酮钠舒巴坦钠组（RR=1.22，95%CI[1.04，1.44]，P=0.02）。咳嗽、咳痰消失时间的结局存在较大异质性，故进行描述性分析。不良反应主要包括皮疹、头晕、胃肠道反应。基于现有数据及分析结果，痰热清注射液联合西药治疗慢性支气管炎急性加重期治愈率更高，且在缩短症状消失时间方面有效果。鉴于纳入研究数量有限、样本量小及方法学质量低，本研究结果需要高质量临床试验进一步验证。
