中西医结合治疗新生儿黄疸的系统综述和Meta分析

目的：系统评价中药联合西药（或物理疗法）治疗新生儿黄疸的临床研究。方法：采用Cochrane系统综述方法，检索2f）02—2012年重庆维普数据库、中国生物医学文献数据库、万方数据库、中文期刊全文数据库等电子资料库，同时手工检索相关的杂志、专业资料、网络信息。由两名评价者共同评价所纳入研究文献的质量，对同质性文献研究进行meta分析。采用Cochrane协作网提供的RevMan4．2．10软件进行meta分析。结果：共检索出144篇文献，符合纳入标准的只有16篇文献，采用1adad评分标准对纳入研究的每篇文献的方法学质量进行评价。16篇文献均未描述具体的随机方法及分配隐藏方法，均未提及是否采用盲法，属于低质量的文献报道。meta分析结果显示，中药联合西药（或物理疗法）治疗组与西药或物理疗法对照组总有效率的比值比为4．97，95％可信区间[354，6．99]，治疗组总有效率高于对照组，差异有统计学意义（P〈0．0（70（）1）。结论：现有l临床资料表明，中药联合西药（或物理疗法）治疗新生儿黄疸较单纯使用西药（或物理疗法）有效，可以改善患者的I临床表现，提高患者的总有效率。但本系统综述纳入的随机对照试验多属低级质量文献，进一步证实其临床疗效有待进一步开展大规模的、设计严谨的、方法可靠的、多中心的、随机对照的临床研究以获得更高强度的临床证据。

Systematic Review and Meta-analysis of Integrative Treatment on Neonatal Jaundice

Objective ： To systematically evaluate the elinical study of Chinese medicine combined with Western medicine （ or physical therapy ） in the treatment of neonatal jaundice. Methods ： By using Cochrane systematic review methods, the Chongqing VIP database, Chinese biomedical literature database, WANFANG database, China academic journal network publishing database and so on were retrieved, and the relative magazines, professional information, network information were manually retrieved. Result： Totally 144 pieces of literature was retrieved, and only 16 pieces of literature met the inclusion criteria. The quality of methods in these literature was evaluated by Jadad evaluation standard. All these didn＇t have random methods and allocation conceahnent methods or mention the use of blinding methods or not, and all belonged to low quality literature. The results of Meta-analysis shown that the ratio of Chinese medicine combined with Western medicine （ or physical lherapy ）group to Western medicine or physical therapy control group was 4.97,95% credibility interval [3.54,6.99], the total effective rate of treatment group was higher than that of control group, which difference was statistically significant （ P〈O.O0001 ）. Con~lusion ： Existing clinical data show that the treatment methods of Chinese medicine combined with Western medicine （ or physical therapy ） have better effect than the method of Western medicine, which can improve the clinic syndromes and increase the total effective rate. Because of the low quality of literature in this research, the clinical effect need to further researeh by large-scale, rigorous designed, reliable, multi-center, randomized, eontrolled clinical study, so as to finally obtain more definite clinical evidence.