中药复方治疗儿童感染后咳嗽有效性与安全性的系统评价OA
Systematic review of efficacy and safety of traditional Chinese medicine compound prescriptions in treating post‑infectious cough in children
目的 系统评价单用中药复方治疗儿童感染后咳嗽(PIC)的临床疗效与安全性.方法 计算机检索中国知网(CNKI)、万方数据知识服务平台(WanFang Data)、维普中文期刊服务平台(VIP)、中国生物医学文献服务系统(SinoMed)、PubMed、Embase、Cochrane Library、Web of Science等数据库中治疗儿童PIC的相关文献,文献发表时间为建库至2024年12月10日.借助Cochrane系统手册评估工具评价文献质量,运用Review Manager 5.4软件进行meta分析.结果 ①本研究共纳入文献17篇,涉及1 296例患儿,其中男性691例、女性605例,年龄1～17岁.②采用RoB 2量表对纳入文献进行偏倚风险评价,提示部分研究存在一定偏倚风险.③meta分析结果显示,试验组在临床有效率、中医证候疗效方面高于对照组[RR=1.18,95%CI(1.13,1.24),P<0.000 01;RR=1.38,95%CI(1.14,1.68),P=0.001];试验组在改善咳嗽、咳痰症状积分及中医证候积分方面优于对照组[SMD=−0.67,95%CI(−0.84,−0.50),P<0.000 01;SMD=−0.52,95%CI(−0.82,−0.21),P=0.000 9;SMD=−1.02,95%CI(−1.21,−0.82),P<0.000 01];试验组在缩短起效时间、治愈时间方面优于对照组[SMD=−1.10,95%CI(−1.82,−0.37),P=0.003;SMD=−0.38,95%CI(−0.71,−0.05),P=0.02];试验组儿童PIC的复发率低于对照组[RR=0.34,95%CI(0.12,0.95),P=0.04];纳入文献中有10篇报告了不良反应情况,均未见不良反应事件发生.结论 与西药相比,单纯使用中药复方治疗儿童PIC能更好地改善咳嗽、咳痰症状及中医证候,提高临床有效率,缩短治疗时间,且安全性高,但纳入的文献数量、质量有限,相关结论有待进一步验证.
Objective To systematically review the clinical efficacy and safety of traditional Chinese medicine(TCM)compound prescriptions in the treatment of post-infectious cough(PIC)in children.Methods A computer-based search was conducted in eight databases,including China National Knowledge Infrastructure(CNKI),WanFang Data,VIP(Chinese Journals Service Platform),SinoMed,PubMed,Embase,Cochrane Library,and Web of Science,for relevant literature on the treatment of PIC in children,with publication dates from the inception of the databases up to December 10,2024.The quality of the included studies was assessed using the Cochrane Handbook for Systematic Reviews of Interventions,and meta-analysis was performed using Review Manager 5.4 software.Results ①A total of 17 studies were included,involving 1,296 children(691 males,and 605 females)aged 1 to 17 years.②The risk of bias in the included studies was assessed using the RoB 2 tool,indicating some studies had potential bias risks.③Meta-analysis results showed that the experimental group had a higher clinical efficacy rate and better TCM syndrome efficacy than the control group[RR=1.18,95%CI(1.13,1.24),P<0.000 01;RR=1.38,95%CI(1.14,1.68),P=0.001].The experimental group also showed better improvement in cough,expectoration,and TCM syndrome scores[SMD=−0.67,95%CI(−0.84,−0.50),P<0.000 01;SMD=−0.52,95%CI(−0.82,−0.21),P=0.000 9;SMD=−1.02,95%CI(−1.21,−0.82),P<0.000 01].The experimental group had a shorter onset and cure time than the control group[SMD=−1.10,95%CI(−1.82,−0.37),P=0.003;SMD=−0.38,95%CI(−0.71,−0.05),P=0.02].The recurrence rate of PIC in children of the experimental group was lower than that in the control group[RR=0.34,95%CI(0.12,0.95),P=0.04].10 articles included in the literature reported adverse reactions,but no adverse events occurred.Conclusions Compared to Western medicine,the use of TCM compound prescriptions alone is more effective in improving cough,expectoration,and TCM syndrome symptoms in children with PIC.It also enhances clinical efficacy,shortens treatment time,and demonstrates high safety.However,the limited number and quality of the included studies require further validation of these findings.
马小敏;刘震;杨雨萌;李骄昌;张天宇;张文涵;吴振起
辽宁中医药大学(辽宁 沈阳 110847)辽宁中医药大学(辽宁 沈阳 110847)大连医科大学(辽宁 大连 116044)辽宁中医药大学(辽宁 沈阳 110847)辽宁中医药大学(辽宁 沈阳 110847)辽宁中医药大学(辽宁 沈阳 110847)辽宁中医药大学附属第二医院(辽宁 沈阳 110034)||沈阳市中医外感病重点实验室(辽宁 沈阳 110034)
感染后咳嗽儿童中药meta分析循证医学
post-infectious coughchildrenChinese materia medicameta-analysisevidence-based medicine
《上海中医药杂志》 2026 (3)
33-43,11
国家自然科学基金项目(81373687,81874490,82074494)辽宁省科技厅应用基础研究计划项目(2022JH2/101300088)
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