热淋清制剂治疗单纯性尿路感染随机对照试验的系统评价

摘要

Objective To assess the clinical effectiveness and safety of relinqing pharmaceutical preparations for the treatment of uncomplicated urinary tract infection(UTI). Methods The genitourinary infection, urinary tract infection, pyelonephritis, cystitis, stranguria and urethritis were used as key words to search at CNKI,VIP,SinoMed,PubMed,Wan Fang and Cochrane Library Databases up to April 2015. Data of randomised controlled trials (RCTs) comparing treatments using relinqing were included in this study. The quality of the literature was evaluated by the method of Cochrane handbook 5.1.0. Data extraction was carried out independently by two authors. RevMan 5.2 software was used for Meta-analysis. Results Five RCTs were included that involved a total of 471 uncomplicated UTIs. Analysis of four studies showed a higher rates of effectiveness for uncomplicated UTI in the treatment with relinqing plus antibiotics than those of antibiotics alone [RR and 95%CI:1.15 (1.08-1.23), P<0.001]. Analysis of two studies showed a higher rates of bacterial clearance for uncomplicated UTI in the treatment with relinqing plus antibiotics than those of antibiotics alone [RR and 95% CI: 4.04 (1.78-9.16)]. Conclusion Data from five small studies suggest that relinqing as an independent intervention or in conjunction with antibiotics may be beneficial for treating uncomplicated UTIs. However, the small number and poor quality of the included studies meant that it is not possible to formulate robust conclusion on the use of relinqing for uncomplicated UTI either alone or as an adjunct to antibiotics.%目的：系统评价热淋清制剂治疗单纯性尿路感染的临床效果和安全性。方法以genitourinary infection、urinary tract infection、pyelonephritis、cystitis、stranguria、urethritis等为检索词，计算机检索万方、CNKI、维普、SinoMed、PubMed、Cochrane Library等6个数据库（建库至2015年4月），收集有关热淋清制剂治疗单纯性尿路感染的临床随机对照试验（RCT）研究文献。对纳入的文献进行筛选及质量评价，提取数据后，采用RevMan5.2软件进行Meta分析。结果共检索出相关文献389篇，最终纳入5篇RCT文献，共471例患者。5个研究均报告了有效率，其中4个同质研究进行Meta分析，结果显示，热淋清制剂联合抗生素治疗单纯性尿路感染有效率高于单用抗生素[合并RR及95%CI为1.15（1.08~1.23），P<0.001]。4个研究报告了细菌清除率，其中2个同质研究合并分析，结果显示，热淋清制剂联合抗生素治疗单纯性尿路感染细菌清除率高于单用抗生素[合并RR及95%CI为4.04（1.78~9.16）]。2个研究报告了复发率，联合抗生素治疗尿路感染复发率低于单用抗生素[合并RR及95%CI为0.31（0.10~0.92）]。结论热淋清制剂联合抗生素治疗单纯性尿路感染疗效优于单用抗生素，但因纳入的RCT文献较少且质量较低，结论有待更高质量研究进一步验证。