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一项关于痰热清注射液联合抗生素与单独使用抗生素治疗脑出血后肺部感染的临床疗效的荟萃分析。

A meta-analysis of the clinical efficacy of Tanreqing injection combined with antibiotics vs antibiotics alone for treating pulmonary infection secondary to intracerebral hemorrhage.

机构信息

Key Laboratory of Chinese Internal Medicine of Educational Ministry and Beijing, Dongzhimen Hospital.

Department of Cardiology, Dongfang Hospital, Beijing University of Chinese Medicine.

出版信息

Medicine (Baltimore). 2021 Mar 19;100(11):e24905. doi: 10.1097/MD.0000000000024905.

Abstract

BACKGROUND

Pulmonary infection is the most common complication to develop after intracerebral hemorrhage (ICH). Antibiotics have certain limitations when used to treat pulmonary infection, while Tanreqing injection (TRQI) is extensively used to treat pulmonary infection as an adjuvant to antibiotics. The aim of this meta-analysis was to investigate the clinical efficacy of TRQI for the treatment of lung infection secondary to ICH.

METHODS

Randomized controlled trials (RCTs) assessing the combination of TRQI and antibiotics compared to antibiotics alone for pulmonary infection after ICH were comprehensively searched for in 7 electronic databases from their establishment to August 2020. Two independent researchers conducted the literature retrieval, screening, and data extraction. The assessment tool of Cochrane risk of bias and Review Manager 5.3 software were applied to assess the methodological quality and analyze the data, respectively.

RESULTS

Seventeen RCTs involving 1122 patients with pulmonary infection after ICH were included. Compared to antibiotics alone, the combination treatment enhanced the clinical effective rate, shortened the hospital stay, reduced the white blood cell, procalcitonin, and C-reactive protein levels, ameliorated the times to the resolution of fever, cough, and lung rales, and increased the oxygenation index. The evidence indicated that TRQI combined with antibiotics caused no adverse reactions.

CONCLUSIONS

Our study showed that the combination of TRQI and antibiotics was effective for treating pulmonary infection after ICH. However, high-quality multicenter RCTs are needed to further verify the clinical efficacy of TRQI due to the publication bias and the low methodological quality of the included RCTs.

摘要

背景

肺部感染是脑出血(ICH)后最常见的并发症。抗生素在治疗肺部感染时有一定的局限性,而痰热清注射液(TRQI)作为抗生素的辅助药物被广泛用于治疗肺部感染。本荟萃分析旨在探讨 TRQI 治疗 ICH 后肺部感染的临床疗效。

方法

全面检索了 7 个电子数据库,从建库到 2020 年 8 月,以评估 TRQI 联合抗生素与单独使用抗生素治疗 ICH 后肺部感染的随机对照试验(RCT)。两名独立的研究人员进行了文献检索、筛选和数据提取。采用 Cochrane 偏倚风险评估工具和 Review Manager 5.3 软件分别评估方法学质量和分析数据。

结果

纳入了 17 项 RCT,共涉及 1122 例 ICH 后肺部感染患者。与单独使用抗生素相比,联合治疗可提高临床有效率,缩短住院时间,降低白细胞、降钙素原和 C 反应蛋白水平,改善发热、咳嗽和肺部啰音的缓解时间,并提高氧合指数。证据表明,TRQI 联合抗生素无不良反应。

结论

本研究表明,TRQI 联合抗生素治疗 ICH 后肺部感染有效。然而,由于纳入 RCT 的发表偏倚和低方法学质量,需要高质量的多中心 RCT 进一步验证 TRQI 的临床疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd93/7982207/45b6abe18455/medi-100-e24905-g001.jpg

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