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中药治疗特发性身材矮小症患儿的系统评价和 Meta 分析。

Chinese herbal medicine for children with idiopathic short stature (ISS): A systematic review and meta-analysis.

机构信息

2nd Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.

Department of Pediatrics, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China.

出版信息

PLoS One. 2022 Jun 24;17(6):e0270511. doi: 10.1371/journal.pone.0270511. eCollection 2022.

Abstract

BACKGROUND

Idiopathic short stature (ISS) describes a heterogeneous group of children of many unidentified causes of short stature presently without definitive therapy. Chinese herbal medicine (CHM) is an alternative and complementary treatment for children with ISS and has been widely used for ISS while the evidence of its effectiveness is controversial. We conducted this systematic review and meta-analysis in order to evaluate the efficacy of CHM for ISS.

METHODS

PubMed, Embase, Web of science, Sino-Med, Cochrane, CNKI, VIP, and Wangfang Data were electronically searched to collect randomized controlled trials (RCTs) of CHM treatment of ISS from inception to May 2021. Two researchers independently scanned the literature and extracted information on general characteristics, including patient, study design, interventions, and side effects, assessing the CHM intervention's efficacy and the risk of bias. Height, bone age, growth velocity, and IGF-1 level are the main consequences. Height standard deviations score (HtSDS), change in HtSDS (ΔHtSDS), osteocalcin, the peak level of growth hormones (GHP), and predicted adult height (PAH) are the secondary outcomes. Meta-analysis was then performed by using RevMan 5.3 (Cochrane Collaboration).

RESULTS

Seven articles (569 participants) were included. The Meta-analysis indicated that herbal medicine was associated with increased height (MD 2.16 points; 95%CI, 0.22 to 4.10; P = 0.03), growth velocity (MD 1.47 points; 95%CI, 0.28 to 2.67; P = 0.02), IGF-1 level (MD 28.13 points; 95%CI, 22.80 to 33.46; P<0.00001) and GHP (MD 3.29 points; 95%CI, 1.54 to 5.04; P = 0.0002).

CONCLUSION

According to current research, CHM appears to be useful for children with ISS. Due to the limited quality and number of studies included, more high-quality studies are needed to corroborate the above conclusions.

摘要

背景

特发性身材矮小症(ISS)描述了一组异质性儿童,其矮小的许多原因目前尚未明确,且尚无明确的治疗方法。中药(CHM)是 ISS 患儿的一种替代和补充治疗方法,已广泛用于 ISS,但其疗效证据存在争议。我们进行了这项系统评价和荟萃分析,以评估 CHM 治疗 ISS 的疗效。

方法

从建库到 2021 年 5 月,我们通过电子检索 PubMed、Embase、Web of science、Sino-Med、Cochrane、CNKI、VIP 和万方数据,收集了关于 CHM 治疗 ISS 的随机对照试验(RCT)。两位研究人员独立扫描文献并提取一般特征信息,包括患者、研究设计、干预措施和副作用,评估 CHM 干预的疗效和偏倚风险。身高、骨龄、生长速度和 IGF-1 水平是主要结果。身高标准差评分(HtSDS)、HtSDS 的变化(ΔHtSDS)、骨钙素、生长激素峰值水平(GHP)和预测成人身高(PAH)是次要结果。然后使用 RevMan 5.3(Cochrane 协作网)进行荟萃分析。

结果

纳入了 7 篇文章(569 名参与者)。荟萃分析表明,草药与身高增加(MD 2.16 分;95%CI,0.22 至 4.10;P = 0.03)、生长速度(MD 1.47 分;95%CI,0.28 至 2.67;P = 0.02)、IGF-1 水平(MD 28.13 分;95%CI,22.80 至 33.46;P<0.00001)和 GHP(MD 3.29 分;95%CI,1.54 至 5.04;P = 0.0002)有关。

结论

根据目前的研究,CHM 似乎对 ISS 患儿有用。由于纳入研究的质量和数量有限,需要更多高质量的研究来证实上述结论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/533e/9232169/5bff14866f1e/pone.0270511.g001.jpg

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