痰热清注射液治疗全身炎症反应综合征的系统评价

摘要

目的：系统评价痰热清注射液治疗全身炎症反应综合征的效果。方法检索Ovid／Pubmed、Embase、中国知网、万方数据知识服务平台、维普期刊资源整合服务平台、中国生物医学文献数据库，查找痰热清注射液治疗全身炎症反应综合征的随机对照试验（RCT），观察指标包括临床总有效率、WBC、血清C-反应蛋白（CRP）、TNF-α、血清降钙素原（ PCT）、体温（ T）。根据Jadad质量评分法对文献质量进行评价。结果最终纳入11篇文献，共811例患者，对照组396例、痰热清组415例。纳入文献质量总体不高，仅1篇为高质量文献。纳入文献存在发表偏倚。与对照组相比，痰热清组总有效率提高（OR＝3．05，95％CI：1．46～6．39，P＝0．003），WBC下降（WMD＝1．39，95％CI：2．25～0．53，P＝0．002），血清CRP（WMD＝13．78，95％CI：19．96～7．60，P＜0．0001）、PCT（SMD＝2．17，95％CI：4．230．11，P＝0．04）、TNF-α（SMD＝－1．50，95％CI：2．14～0．85，P＜0．00001）、IL-6（WMD＝－24．04，95％CI：36．03～12．05，P＜0．0001）降低，T降低（WMD＝－0．66，95％CI：0．85～0．47，P＜0．0001）。所有文献未报告痰热清注射液有不良反应。结论痰热清注射液治疗全身炎症反应综合征效果较好。%Objective To evaluate the efficacy of Tanreqing injection in treatment of systemic inflammatory response syndrome (SIRS) systematically.Methods We retrieved Ovid/Pubmed, Embase, CNKI, Wanfang data, VIP and Chi-nese biomedical literature database to search for the randomized controlled trial ( RCT) of Tanreqing injection in the treat-ment of SIRS , and then we observed the following indexes , including the clinical total effective rate , white blood cell count (WBC), serum C-reactive protein (CRP) and serum tumor necrosis factor-α(TNF-α), serum calcitonin (PCT) and tem-perature ( T) .According to the Jadad quality evaluation , we evaluated the literatures .Results Eleven trials were eligible finally, and contained 811 cases of patients including 396 patients treated with conventional treatment and 415 with Tan-reqing injection based on conventional treatment , only one literature was of high-quality.Meta analysis showed that the therapeutic effect of SIRS treated with Tanreqing injection was better than that treated by routine alone , and it reflected mainly in the following:the total clinical efficiency was increased (OR=3.05, 95%CI:1.46-6.39, P=0.003), the level of WBC (WMD=1.39,95%CI:2.25 to 0.53, P=0.002), the level of CRP (WMD=13.78, 95%CI:19.96 to 7.60, P<0.00 01), the level of PCT (SMD=2.17, 95%CI:4.23 to 0.11, P=0.04), the level of TNF-α(SMD=-1.50, 95%CI:2.14 to 0.85, P<0.00 001), and the level of IL-6 (WMD=-24.04,95%CI:36.03 to 12.05, P<0.00 01) were decreased, ant the level of T was decreased (WMD=-0.66, 95%CI:0.85 to 0.47, P<0.00 01).No serious adverse reactions were reported .Conclusion Tanreqing injection has good effect in treatment of SIRS .