茵栀黄注射液治疗新生儿黄疸的系统评价

目的评价茵栀黄注射液治疗新生儿黄疸的疗效性和安全性。方法计算机检索PubMed、EMBASE、Cochrane Library、中国期刊全文数据库、中国生物医学文献数据库、中文科技期刊全文数据库等数据库,全面收集有关茵栀黄注射液治疗新生儿黄疸的临床随机对照试验,按照Cochrane系统评价手册推荐的评价方法对纳入研究的质量进行评价,并对符合纳入标准的随机对照试验进行Meta分析。结果共纳入25篇随机对照试验。Meta分析结果显示:与常规治疗组相比,茵栀黄注射液结合常规疗法治疗新生儿黄疸在治疗有效率[OR=8.10,95%CI(5.68,11.55)]、改善血胆红素值[治疗3 d MD=-69.31,95%CI(-76.22,-62.39),治疗5 d MD=-45.59,95%CI(-52.13,-39.05)];治疗7 d MD=-22.22,95%CI(-35.88,-8.57)]及皮测胆红素值[治疗5 d MD=-57.69,95%CI(-79.82,-35.56),治疗3 d MD=-51.62,95%CI(-72.63,-30.61)]、调节日均血胆红素[下降值MD=12.26,95%CI(8.94,15.58)]和退黄天数[MD=-1.83,95%CI(-2.06,-1.59)]方面都有一定疗效。结论与常规治疗组相比,茵栀黄注射液结合常规疗法治疗新生儿黄疸可能有效,但由于纳入研究存在一定的质量缺陷,因而,对茵栀黄注射液治疗新生儿黄疸的有效性和安全性尚不能得出肯定的结论,还需更多高质量、多中心的随机对照试验作进一步证实。

Treating Neonatal Jaundice with Yinzhihuang Injection: A Systematic Review

Objective To evaluate the effectiveness and safety of Yinzhihuang in treatment of neonatal jaundice. Methods Biomedical databases, including Medline, EMBASE, the Cochrane Library, CBM-disk, CNKI and VIP were retrieved. Randomized controlled trials （RCTs） on Yinzhihuang in treatment of Neonatal jaundice were collected. A critical quality assessment and Meta-analysis were performed for the included studies. RevMan5 was used for statistical analysis. Results 25 randomized controlled trials were included. Meta-analysis results showed that compared with the control group, Yinzhihuang showed significant positive effects on the effective rate [OR=8.10 and 95%CI （5.68, 11.55）], improving the billrubin levels [after treating three days, MD：-69.31 and 95%CI （-76.22, -62.39）, after treating five days, MD=45.59 and 95%CI （-52.13, -39.05）, after treating seven days, MD =22.22 and 95%CI （-35.88, -8.57）] and percutaneous value [after treating five days, MD：-57.69 and 95%CI （-79.82, -35.56）, after treating three days, MD=51.62 and 95%CI （-72.63, -30.61）], regulating the average bilirubin levels descend value [MD： 12.26 and 95%CI （8.94, 15.58）] and the days of removing jaundice （MD -1.83 and 95%CI -2.06 to -1.59）. Conclusion Compared with the control group, Yinzhihuang could be effectively in treating neonatal jaundice but because there are different degrees of clinical research quality, no reliable conclusion can be drawn from our Meta-analysis about its efficacy and safety. Well-designed, multicenter randomized clinical trials are urgently needed to evaluate the value and safety of Yinzhihuang in treating neonatal jaundice.