痰热清注射液联合抗生素治疗卒中相关性肺炎临床疗效的Meta分析

目的 系统评价痰热清注射液联合抗生素治疗卒中相关性肺炎的临床疗效。方法 利用计算机检索从建库到2019年12月30日的中国期刊全文数据库(知网,CNKI)、中国学术期刊数据库(万方数据,WanFang Data)、中文科技期刊数据库(维普,VIP)、Cochrane 图书馆临床对照试验资料库及 PubMed 数据库,收集有关痰热清注射液联合抗生素治疗卒中相关性肺炎的随机对照试验,并手工检索纳入文献的参考文献,扩大检索范围。采用RevManManger 5.3软件对纳入文献进行Meta 分析。结果 共纳入随机对照试验(randomized controlled trial,RCT)文献18篇,受试者1 267例。Meta分析结果提示,痰热清注射液联合抗生素治疗卒中相关性肺炎有效率高于单纯抗生素,[OR=4.45,95%CI(2.97～6.66),P＜0.01];痰热清注射液联合抗生素治疗卒中相关性肺炎较单纯抗生素,白细胞计数降低更明显, [MD=-0.93,95%CI(-1.57～-0.28),P =0.005];痰热清注射液联合抗生素治疗卒中相关性肺炎较单纯抗生素,CRP降低更明显,[MD=-7.02,95%CI(-13.72～0.32),P =0.04];痰热清注射液联合抗生素治疗卒中相关性肺炎较单纯抗生素,体温恢复更快,其差异有统计学意义,[MD=-0.82,95%CI(-0.97～-0.67),P＜0.001];痰热清注射液联合抗生素治疗卒中相关性肺炎较单纯抗生素,肺部啰音消失时间无差异,其差异无统计学意义,[MD=-1.78,95%CI(-4.03～0.47),P =0.12];痰热清注射液联合抗生素治疗卒中相关性肺炎较单纯抗生素,住院时间更短,其差异有统计学意义,[MD=-7.02,95%CI(-13.72～-0.32),P＜0.01]。结论 痰热清注射液联合抗生素治疗卒中相关性肺炎较单纯抗生素治疗,症状改善有效率更高,体温恢复更快,住院时间更短,不能加快肺部啰音消失。

Clinical efficacy of tanreqing injection combined with antibiotics in treatment of stroke associated pneumonia: a Meta analysis

Objective To systematically evaluate the clinical efficacy of tanreqing injection combined with antibiotics in the treatment of stroke associated pneumonia. Methods From the establishment of the database to December 30, 2019, CNKI, Wanfang Data, VIP, Cochrane Library clinical controlled trials database, and PubMed database were searched by computer to collect the randomized controlled trials on tanreqing injection combined with antibiotics in the treatment of stroke associated pneumonia, and then the references of the literature included were manually searched to expand the search scope. Meta-analysis of the included literature was performed by using RevMan5.3 software. Results A total of 18 randomized controlled trials (RCTs) with 1 267 subjects were included. Meta analysis showed that the effective rate of tanreqing injection combined with antibiotics in the treatment of stroke associated pneumonia was higher than that of antibiotics alone ; Compared with antibiotics alone, tanreqing injection combined with antibiotics in the treatment of stroke associated pneumonia had a more significant decrease in white blood cell count ; Compared with antibiotics alone, tanreqing injection combined with antibiotics had a more significant decrease in CRP ; Compared with antibiotics alone, tanreqing injection combined with antibiotics had faster recovery of body temperature ; there was no significant difference in the disappearance time of pulmonary rales between tanreqing injection combined with antibiotics and antibiotics alone in the treatment of stroke associated pneumonia ; tanreqing injection combined with antibiotics in the treatment of stroke associated pneumonia had shorter hospitalization time than antibiotics alone, and the difference was statistically significant. Conclusion Compared with the simple antibiotics, tanreqing injection combined with antibiotics in the treatment of stroke associated pneumonia has higher effective rate of symptom improvement, faster recovery of body temperature, shorter hospitalization time, but cannot accelerate the disappearance of lung rales.