Huang Peiying, Li Yin, Huang Bixuan, Zhao Shuai, Chen Li, Guan Hansu, Chen Yan, Feng Yuchao, Huang Xiaoyan, Deng Yi, Lei Sisi, Wu Qihua, Zhang Haobo, Zeng Zhongyi, Zeng Linsheng, Chen Bojun
The Second Clinical Medical School of Guangzhou University of Chinese Medicine, Guangzhou, China.
Guangdong Provincial Key Laboratory of Research on Emergency in Traditional Chinese Medicine, Clinical Research Team of Prevention and Treatment of Cardiac Emergencies with Traditional Chinese Medicine, Guangzhou, China.
Front Pharmacol. 2022 Jun 17;13:888073. doi: 10.3389/fphar.2022.888073. eCollection 2022.
Acute tonsillitis has high morbidity. Chinese herbal injections (CHIs) were reported to be useful in treating acute tonsillitis and might reduce the probability of antibiotic resistance. Nevertheless, the optimal strategy for combining CHIs with western medicine (WM) to treat acute tonsillitis remains unclear. We retrieved data from the following databases with retrieval time from inception to 11 January 2022: PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, Weipu Journal Database, and Chinese Biomedical Literature Database. Version 2 of the Cochrane risk-of-bias tool (ROB2) was used for evaluating the quality of the included studies. R 4.1.2, STATA 14.0, and Python 3.10.4 were employed for network meta-analysis, with 5-dimensional K-means cluster analysis, meta-regression analyses, sensitivity analyses, and subgroup analyses. A total of 110 randomized controlled trials including 12,152 patients were included. All the studies were rated as "high risk" and "some concerns". In terms of improving clinical effectiveness rate, Qingkailing injection + WM ranked ahead of other interventions (89.51%). Regarding reducing antipyretic time, Reduning injection + WM had the highest-ranking probability (68.48%). As for shortening sore throat relief time, Shuanghuanglian injection + WM ranked first (76.82%). Concerning shortening red and swollen tonsils relief time, Yanhuning injection + WM possessed the highest-ranking probability (89.17%). In terms of reducing tonsillar exudate relief time, Xuebijing injection + WM ranked ahead of the other interventions (94.82%). Additionally, the results of the cluster analysis suggested that Xuebijing injection + WM, Reduning injection + WM, and Yanhuning injection + WM were probably the best interventions. Furthermore, adverse drug reactions rate of Xuebijing injection + WM, Reduning injection + WM, Yanhuning injection + WM, Qingkailing injection + WM, and Shuanghuanglian injection + WM were individually 0.00%, 3.11%, 3.08%, 4.29%, and 4.62%. CHIs + WM have a better impact on patients with acute tonsillitis than WM alone. Xuebijing injection, Reduning injection, and Yanhuning injection might have potential advantages in treating the disease. Concerning adverse drug reactions, Xuebijing injection is presumably the optimal CHI. More high-quality studies are needed to further confirm our findings. CRD42022303243; URL= https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=303243.
急性扁桃体炎发病率高。据报道，中药注射剂（CHIs）可用于治疗急性扁桃体炎，并可能降低抗生素耐药的概率。然而，CHIs与西药（WM）联合治疗急性扁桃体炎的最佳策略仍不明确。我们从以下数据库检索了从建库至2022年1月11日的数据：PubMed、Embase、Web of Science、Cochrane图书馆、中国知网、万方数据库、维普期刊数据库和中国生物医学文献数据库。使用Cochrane偏倚风险工具（ROB2）第2版评估纳入研究的质量。采用R 4.1.2、STATA 14.0和Python 3.10.4进行网络荟萃分析，并进行五维K均值聚类分析、meta回归分析、敏感性分析和亚组分析。共纳入110项随机对照试验，涉及12152例患者。所有研究均被评为“高风险”和“有一些担忧”。在提高临床有效率方面，清开灵注射液+西药排名高于其他干预措施（89.51%）。在缩短退热时间方面，热毒宁注射液+西药排名概率最高（68.48%）。在缩短咽痛缓解时间方面，双黄连注射液+西药排名第一（76.82%）。在缩短扁桃体红肿消退时间方面，炎琥宁注射液+西药排名概率最高（89.17%）。在缩短扁桃体渗出物消退时间方面，血必净注射液+西药排名高于其他干预措施（94.82%）。此外，聚类分析结果表明，血必净注射液+西药、热毒宁注射液+西药和炎琥宁注射液+西药可能是最佳干预措施。此外，血必净注射液+西药、热毒宁注射液+西药、炎琥宁注射液+西药、清开灵注射液+西药和双黄连注射液+西药的药物不良反应发生率分别为0.00%、3.11%、3.08%、4.29%和4.62%。CHIs+西药对急性扁桃体炎患者的影响优于单纯西药。血必净注射液、热毒宁注射液和炎琥宁注射液在治疗该病方面可能具有潜在优势。关于药物不良反应，血必净注射液可能是最佳的中药注射剂。需要更多高质量的研究来进一步证实我们的发现。CRD42022303243；网址= https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=303243 。
