小青龙汤治疗小儿咳嗽变异性哮喘的Meta分析

目的:系统评价小青龙汤(Xiaoqinglong Tang)治疗小儿咳嗽变异性哮喘(cough variant asthma,CVA)的临床疗效。方法:计算机检索Cochrane Library,Pubmed,Embase,中国期刊全文数据库(CNKI),中国生物医学文献数据库(CBM),中国科技期刊全文数据库(VIP)和万方数据库等,检索时间限定为建库至2015年6月,检索所有小青龙汤治疗小儿咳嗽变异性哮喘的随机对照试验(randomized controll trials,RCTs),并追索纳入研究的参考文献。由两位评价者独立对纳入研究的质量进行严格评价和资料提取后,采用Rev Man 5.3软件进行Meta分析。结果:最终纳入10个研究,共961例患者。Meta分析结果显示:与单纯使用西医治疗方案相比,小青龙汤治疗能显著提高小儿咳嗽变异性哮喘的临床有效率[OR=2.49,95%CI(1.12,5.54),P=0.000 2],其差异具有统计学意义。不良反应方面,只有1项研究报道了治疗中出现的不良反应,包括患儿的烦躁、嗜睡、恶心等反应;治疗组患儿在治疗的过程中没有这样的情况出现(发生率为0);而对照组有5例患儿出现过类似的反应(发生率为13.89%,P0.05),两者差异具有统计学意义。结论:小青龙汤治疗小儿咳嗽变异性哮喘能显著提高临床有效率。但本系统评价纳入的所有研究方法学和报告质量均较低,且样本量较少,故小青龙汤治疗小儿咳嗽变异性哮喘的疗效以及安全性仍需要严格的、大样本的随机双盲试验加以验证。

Meta-analysis of Xiaoqinglong Tang on Cough Variant Asthma in Children

Objective: To systematically evaluate the safety and efficacy of Xiaoqinglong Tang in treating cough variant asthma in children. Method: We searched Cochrane Library, Pubmed, Embase, CNKI, CBM, VIP and Wanfang Data through computer for data as at June 2015.All of randomized controlled trials(RCTs) of Xiaoqinglong Tang in treating on cough variant asthma in Children were searched, and research literatures included in the RCTs were also traced. Two researchers independently conducted the strict quality evaluation and data extraction for the included studies and made a Meta-analysis by using RevMan 5.3 software. Result: Totally 10 RCTs involving 961 patients were included into the study. The Meta-analysis results showed that compared with the pure application of western medicine, Xiaoqinglong Tang can significantly improve the clinical effective rate[OR=2.49, 95%CI(1.12, 5.54), P=0.0002], with statistical significant differences. In terms of adverse reactions, only one study showed adverse reactions, including irritability, sleepiness and nausea reaction in children. The treatment group showed no such problem in the process of treatment(0). While the control group had 5 cases with similar adverse reactions(13.89%, P<0.05), with statistically significant differences in both groups. Conclusion: Xiaoqinglong Tang in treating cough variant asthma in children can effectively improve the clinical effective rate. However, due to the low methodology and quality and small sample size of included RCTs in this study, more randomized, double-blind trials with a large sample size are required to further verify the efficacy and safety of Xiaoqinglong Tang in treating cough variant asthma in children.