双黄连注射剂辅助治疗肺炎随机对照试验的系统评价

目的:评价双黄连注射剂辅助治疗肺炎的疗效和安全性。方法:检索中文期刊全文数据库(CNKI)、万方数据库、中文科技期刊数据库(VIP)、中国生物医学文献数据库(CBM)、PubMed、Cochrane临床试验数据库。纳入1990年—2010年公开发表在国内外关于双黄连注射剂治疗肺炎随机对照试验的文献,根据纳入标准及排除标准选择相关文献,并根据文献的不同干预措施进行分层分析:双黄连组(双黄连+西医常规治疗)与单纯西医常规治疗组比较、双黄连组(双黄连+西医常规治疗)与痰热清组(痰热清+西医常规治疗)比较。采用CochraneRev Man 5.0软件进行荟萃分析(Meta分析)。结果:符合纳入标准的论文共有8篇。Meta分析结果显示,双黄连组与单纯西医组相比(共6篇),有效率优势比(OR)为3.97,95%可信区间(95%CI)为[2.02,7.81];痊愈率OR为3.78,95%CI为[2.09,6.83];肺部湿啰音消失时间权重均数差(WMD)为-1.37,95%CI为[-1.76,-0.98];X线恢复正常时间WMD为-1.40,95%CI为[-2.73,-0.08],两组上述各指标比较,差异均有统计学意义。双黄连组优于单纯西医组(P<0.05,P<0.01)。双黄连组与痰热清组比较(共2篇),有效率OR为0.43,95%CI为[0.19,0.96],痰热清组优于双黄连组(P<0.05)。未见报道与双黄连临床应用相关严重不良反应。结论:辅以双黄连注射剂治疗肺炎在综合疗效、肺部湿啰音消失时间、X线恢复正常时间方面优于单纯西医常规治疗。由于本次系统评价纳入研究质量所限,尚需开展高质量的研究进一步分析。     

双黄连注射剂与抗生素比较治疗小儿肺炎疗效的系统评价

目的评价双黄连注射剂(粉针剂和注射液)与抗生素比较治疗小儿肺炎的有效性和安全性。方法计算机检索CBM(1979～2009)、CNKI(1979～2009)、VIP(1989～2009)、PubMed,全面搜集有关双黄连粉针剂/注射液与抗生素对照治疗小儿肺炎的随机对照试验,并按照纳入标准对文献进行筛选,资料提取和质量评价,质量评价参照Cochrane Hand-book for Systematic Reviews of Interventions 5.0.20标准,数据分析采用RevMan 5.0.20。结果有9篇文献纳入评价。5个研究采用退热天数为指标,合并WMD=-1.13,95%CI[-2.05,-0.21]。5个研究分析了啰音消失天数,WMD=-2.58,95%CI[-3.76,-1.41]。5个研究的报告了住院天数,WMD=-2.27,95%CI[-2.67,-1.87]。4个研究的报告了止咳天数,WMD=-4.56,95%CI[-4.67,-4.44]。两个研究的X线诊断炎症消失天数的WMD=-1.23,95%CI[-1.41,-1.05]。共有7篇文献提到了不良反应,但均未交代具体情况,如发生人数、具体症状及处理措施。结论治愈率与抗生素比较,组间差异无统计学意义,但退热、止咳、住院天数等疗效优于抗生素,组间差异有统计学意义。研究结果提示:双黄连与抗生素对照在治疗小儿肺炎有一定的优势,但由于纳入文献质量较低,影响了证据的强度;儿童用药是否受益大于风险,尚不确定。     

双黄连口服液或联合常规治疗小儿急性上呼吸道感染的Meta分析

目的评价双黄连口服液联合常规治疗小儿急性上呼吸道感染的临床疗效和安全性。方法通过检索常用的数据库中的双黄连口服液或者联合常规治疗小儿急性上呼吸道感染的随机对照试验,由2名研究人员独立进行文献的筛选,对最终符合纳入标准的文献进行数据提取和Meta分析。结果双黄连口服液或者联合常规治疗的疗效和安全性优于常规治疗,双黄连口服液联合利巴韦林的疗效和安全性优于单用利巴韦林,单用双黄连口服液的临床疗效优于单用利巴韦林,在发热消退时间上结果无统计学意义。结论双黄连口服液或者联合常规治疗的疗效和安全性优于常规治疗。由于纳入研究数量少,质量偏低,影响研究结果的可靠性和真实性,因此尚需更多多中心、大样本、设计合理、高质量的随机对照试验来进一步验证。     

双黄连注射剂不良反应文献的系统评价

收集近十几年来有关双黄连注射剂的临床研究文献８５篇，参考系统性评价的方法进行定量分析。文献总共报告１０３３１例使用双黄连注射的病例，及其出现不良反应２１５例２２５例次，该药不良反应的平均发生率为２．２２％，其中以变态反应的发生率最高（１．３９％），其次为消化系统反应（０．５１％）和局部静脉炎（０．１８％），其所致各类不良反应中也以变态反应占多数（占６４％），消化系统反应（占２３．５６％）及局部静脉     

双黄连粉针剂治疗急性上呼吸道感染30例

目的观察双黄连粉针剂治疗急性上呼吸道感染的疗效。方法将60例急性上呼吸道感染患者随机平均分为两组,对照组常静脉滴注利巴韦林注射液,观察组静脉滴注双黄连粉针剂,每天1次,疗程为3～5天。结果观察组患者咳嗽消失时间、咽痛消失时间和体温恢复正常时间较对照组明显缩短,治愈率显著提高。结论双黄连粉针剂能够有效治疗急性上呼吸道感染,可以缩短患者病情主要症状的持续时间。     

双黄连粉针治疗小儿急性上呼吸道感染疗效观察

目的观察双黄连粉针治疗小儿急性上呼吸道感染的临床疗效。方法75例患者给予抗生素、止咳化痰以及病毒唑等西医常规治疗基础上加用双黄连粉针静滴。结果75例中治愈61例,显效8例,好转4例,无效2例。结论双黄连粉针治疗小儿急性上呼吸道感染疗效满意。     

双黄连粉针剂治疗小儿急性上呼吸道感染疗效观察

目的:观察双黄连粉针剂治疗小儿急性上呼吸道感染的临床疗效。方法:运用双黄连粉剂治疗小儿急性上呼吸道感染68例(治疗组)与利巴韦林注射液治疗62例(对照组)作疗效比较,3～7 d为1个疗程。两组患儿均采用对症、支持等常规治疗。结果:在退热、止咳以及缩短住院时间等方面治疗组均明显优于对照组(P0.05),且未见明显不良反应发生。结论:双黄连粉剂具有抗病毒,抗细菌感染的双重效果,治疗小儿急性上呼吸道感染疗效显著。     

双黄连粉针治疗小儿急性上呼吸道感染46例

小儿上呼吸道感染(以下简称"上感")是儿科最常见的疾病,临床主要表现为鼻咽部黏膜发炎的局部症状及发热、咳嗽、流涕等全身症状,其发病率占儿科疾病之首,90%为病毒所致。     

双黄连粉针剂治疗上呼吸道感染疗效观察

1997— 2 0 0 2年 ,我院单纯使用双黄连粉针剂治疗上呼吸道感染患者 41 0例 ,取得较好疗效 ,现总结如下。1　临床资料1 1　一般资料　 41 0例患者中 ,男 2 1 0例 ,女 2 0 0例 ;年龄 6个月～ 1 0岁 60例 ,1 1～ 2 0岁 90例 ,2 1～ 30岁 93例 ,31～ 40岁 90例 ,41～ 60岁 77例。均表现为不同程度的发热、咳嗽、鼻塞、流涕、咽部不适、扁桃体肿大、乏力、食欲不振、腹痛、头痛等。1 2　治疗方法　成人予双黄连粉针剂 2 .4～ 3 .6ｇ +5 %葡萄糖液 2 50ｍＬ静滴 1次 /ｄ ;小儿为 60ｍｇ/ｋｇ静滴 1次 /ｄ。1 3　疗效评定标准　痊愈 :治疗 4ｄ…     

Chinese herbal medicine for subacute thyroiditis: a systematic review of randomized controlled trials

Objective

To evaluate the effectiveness and safety of Chinese herbal medicine (CHM) in the treatment of subacute thyroiditis.

Methods

Randomized controlled trials found in PubMed, Cochrane Library, and three Chinese databases were selected. RevMan 5.2 software was used to analyze the data with relative risk or mean difference, expressed with 95% of confidence interval. The quality of trials was assessed and graded the quality of evidence with GRADE profiler software.

Results

Twenty one studies were included. CHM was superior to Western Medicine (include prednisone and NSAIDs) in abating fever, relieving thyroid pain, recovering blood sedimentation, improving thyroid function, and preventing hypothyroidism (P<0.05), while no statistical differences were found in eliminating goiter and reducing relapse rate. CHM plus Western Medicine were superior to Western Medicine in abating fever, relieving thyroid pain, eliminating goiter, and reducing relapse rate, while no statistical differences (P>0.05) were found in recovering blood sedimentation and improving thyroid function. The incidence of adverse reactions in treatment group was lower than that in control group (relative risk was 0.12 and 95% confidence interval was 0.03-0.51). The methodological quality of trials is generally poor with a high risk of bias.

Conclusion

CHM (particularly CHM combined with Western Medicine) used to treat subacute thyroiditis may improve clinical symptoms and signs, reduce relapse rate, and alleviate the side effects of hormones. Due to poor methodological quality of included trials, further more high-quality studies are warranted to confirm the effectiveness and safety of CHM.     

Efficacy of fire-needle for acne: a systematic review and meta-analysis of randomized controlled trials

Objective

To evaluate the efficacy of fire-needle therapy for acne to provide an objective basis for clinical decisions.

喜炎平注射液治疗小儿上呼吸道感染疗效和安全性的系统评价

目的:探讨喜炎平注射液和利巴韦林注射液治疗小儿上呼吸道感染的临床疗效及安全性。方法:计算机检索Pub Med、EMbase、The Cochrane Library、中国期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、万方数据库(Wan Fang Data)和维普中文科技期刊全文数据库(VIP),关于喜炎平注射液和利巴韦林注射液比较治疗小儿上呼吸道感染的随机对照试验(RCTs),检索时限均从建库至2017年1月22日。由两位研究员按纳入和排除标准严格筛选文献、进行质量评价、提取数据后采用Rev Man5.3软件进行Meta分析。结果:最终纳入10个研究,共1486名患者。Meta分析结果显示,喜炎平注射液治疗的总有效率显著高于利巴韦林注射液,在退热时间、咳嗽缓解时间、咽痛缓解时间、鼻塞流涕消失时间等方面有明显优势。两组在不良反应恶心呕吐发生率上的差异没有统计学意义。结论:喜炎平注射液治疗小儿上呼吸道感染在主要临床症状改善方面明显优于利巴韦林注射液,安全性的分析需要大样本量的随机试验加以验证。     

Manipulation for degenerative lumbar spondylolisthesis: A systematic review of randomized controlled trialsOA

Objective: To assess the effectiveness and safety of manipulation intervention for degenerative lumbar spondylolisthesis(DLS).Methods: This is a systematic review and meta-analysis. A full-scale retrieval method was performed until February 1, 2021, including nine databases. The homogeneity of different studies was summarized using the Review Manager. The quality of studies was determined with the Cochrane risk-of-bias tool.The evidence quality was graded with the Grading of Recommendations, Ass...     

Evidence base of randomized controlled trials and guideline recommendations of patent Traditional Chinese Medicines for uncomplicated acute lower respiratory tract infections in adults

OBJECTIVE:To compare clinical practice guideline recommendations on the use of oral patent Traditional Chinese Medicines(PTCMs) for uncomplicated acute lower respiratory tract infections(ALRTIs)in adults with the existing evidence using results of a systematic review of randomized controlled trials(RCTs).METHODS:A systematic review on RCTs and a systematic review of current guidelines on orally taken PTCMs for uncomplicated ALRTIs were performed.Pub Med,Cochrane Library,EMBASE and four Chinese databases were searched from inception to September 2016 for RCTs testing orally taken PTCMs for uncomplicated ALRTIs(excluding pneumonia).Two reviewers independently screened each study,extracted study data,and assessed risk of bias.Disagreements were resolved through discussion or by consultation with a third reviewer.Clinical practice guidelines for uncomplicated ALRTIs containing PTCM recommendations were identified and quality appraised.The quality of pooled evidence of the RCTs and the guidelines was assessed with GRADE and AGREE Ⅱ respectively.The consistency of the evidence base in RCTs and the guideline recommendations were then compared.RESULTS:For the systematic review of RCTs,4810 papers were identified,among which 29 RCTs(5093 patients) were included in the review.PTCMs compared to placebo increased the effective treatment rate of cough(3 trials,949 patients,risk ratio(RR) 2.50,1.16 to 5.43;low certainty);improved assessment of global health(3 trials,948 patients,RR1.70,1.44 to 2.01;low certainty);and increased the effective rate of specific symptom relief(1 trial,478 patients,RR 4.01,2.76 to 5.81;moderate certainty).21 trials(3432 patients) compared effects of different PTCMs.For the guideline evaluation,29 PTCMs were recommended for the use of uncomplicated ALRTIs,of which27 had no supportive evidence from RCTs.CONCLUSION:The evidence base of PTCMs for uncomplicated ALRTIs is weak and the guideline recommendations were based on almost no clinical trial evidence.Rigorous clinical research is urgently needed to inform the clinical use of these herbal medicines.Further training in evidence-based medicine methods for Traditional Chinese Medicine guideline developers is essential.     

Traditional Chinese medicine for acute mountain sickness prevention:A systematic review and meta-analysis of randomized controlled trialsOA

Objective: To evaluate the efficacy of traditional Chinese medicine(TCM) for preventing acute mountain sickness(AMS).Methods: We included randomized controlled trials(RCTs) which evalueded the effect of TCM for preventing AMS, compared with a placebo, no treatment or acetazolamide. The literature was searched in 6major databases. RevMan 5.4 software was used for the meta-analysis. The relative risk for discrete variables and the mean difference for continuous variables with 95% confidence interv...     

中药复方干预亚健康随机对照试验的系统评价

目的:评价中药复方干预亚健康的有效性和安全性,为临床干预亚健康提供证据。方法:通过检索Cochranelibrary,MEDLINE,EMBASE,CBM和CNKI数据库(截至2008年12月),全面搜集有关中药复方干预亚健康的随机对照试验,并对文献进行筛选,资料提取和质量评价,质量评价参照Cochrane handbook 5.0标准,数据分析采用Revman 5.0。结果:有8篇文献(合计1487例患者)纳入系统评价。由于纳入研究间临床异质性较大,不能进行定量合并分析,只做描述性分析:4个研究采用了有效率指标,95%可信区间均在右侧;6个涉及躯体症状研究的95%可信区间均在左侧,1个采用HRV指标和2个涉及生活质量改善状况研究的95%可信区间均在右侧。8篇文献中只有一篇提到不良反应,不良反应主要表现为口干和便干,与对照组不良反应比较无统计学差异(P>0.05)。结论:基于以上研究分析,中药复方干预亚健康在改善特异症状和生活质量方面有显著疗效,但由于中药复方干预亚健康的随机对照研究开展较少,纳入研究质量较低,其有效性和安全性有待进一步深入研究。     

Efficacy of Chinese herbal medicine for lumbar disc herniation: a systematic review of randomized controlled trials

Objective

This is a review of the effects of Chinese herbal medicine (CHM) used alone to treat lumbar disc herniation (LDH).

METHORDS

A literature search of the following electronic databases from their inception to February 2013 was conducted: Chinese Biomedical databases, Chinese National Knowledge Infrastructure, Wanfang Database, China Science and Technology Journal Database, Cochrane Library, Web of Science, MEDLINE, and EMBASE. Randomized controlled trials where CHM had been used to treat LDH were selected. Data extraction, quality assessment, and data analysis were carried out by two independent reviewers.

Results

Of the 2415 studies identified, eight with complete data on 1146 patients were selected. The methodological quality was poor in all trials. Five studies reported that CHM was better than Western Medicine [OR=2.81, 95% CI (1.27, 6.18); OR=3.34, 95% CI (1.92, 5.79); OR=2.22, 95% CI (1.08, 4.57); OR=6.67, 95% CI (1.34, 33.28); and OR=1.94, 95% CI (1.23, 3.06)]. Two studies reported that the clinical outcome was better in CHM groups than in physiotherapy and placebo groups, [OR=3.02, 95% CI (1.08, 8.46); and OR=2.67, 95% CI (1.26, 5.64), respectively], whereas one study reported no difference between CHM and physiotherapy groups. One study reported that CHM resulted in higher Japanese Orthopedic Association scores [MD=7.78, 95% CI (6.67, 8.89)] than in a control group and another that participants treated with CHM had lower Visual Analogue Scale scores [MD= − 0.72, 95% CI (− 0.86, − 0.58)] than those in a control group. Three studies reported that the adverse effects of CHM and Western Medicine did not differ significantly [OR=0.10, 95% CI (0.01, 1.85); OR=0.19, 95% CI (0.01, 4.07); and OR=0.07, 95% CI (0.00, 1.32)].

Conclusion

CHM may be more effective than other interventions for LDH; however, methodological weaknesses in the studies assessed in this review prevent a definitive conclusion. More high-quality large-scale studies are required to clarify this matter.