連花清瘟膠囊輔助治療社區獲得性肺炎效果及安全性的Meta分析

周珍+王素美+劉艷萍

[摘要] 目的 評價連花清瘟膠囊治療社區獲得性肺炎的效果及安全性。 方法 檢索Medline、The Cochrane Library、PubMed、萬方數據庫、維普數據庫、中國知網、中國生物醫學文獻數據庫，收集連花清瘟膠囊聯合常規西醫療法治療社區獲得性肺炎的隨機對照試驗，檢索時限均為建庫到2016年12月。按照納入及排除標準篩選研究，參照Jadad記分方法評價文獻質量，Meta分析采用Rev Man 5.3軟件。 結果 共納入隨機對照試驗6篇。連花清瘟膠囊聯合治療有效率顯著高于單純西醫治療（OR=1.70，95%CI：1.15～2.52，P=0.008），退熱時間（WMD=-2.33，95%CI：-2.52～-2.13，P < 0.00 001）、咳嗽好轉時間（WMD=-2.63，95%CI：-2.84～-2.41，P < 0.00001）、影像學轉歸時間（WMD=-1.95，95%CI：-2.73～-1.18，P < 0.00 001）均顯著短于單純西醫治療，差異有統計學意義。2項研究報道了不良反應，連花清瘟膠囊聯合治療與單純西醫治療的不良反應差異無統計學意義（P > 0.05）。 結論 連花清瘟膠囊聯合治療社區獲得性肺炎可改善有效率，縮短癥狀緩解時間、影像轉歸時間，不良反應少，對社區獲得性肺炎有很好的輔助治療作用。受文獻質量以及數量影響，上述結論仍需擴大樣本量，選取高質量文獻進行進一步的驗證。

[關鍵詞] 連花清瘟膠囊；社區獲得性肺炎；系統評價；Meta分析

[中圖分類號] R563 [文獻標識碼] A [文章編號] 1673-7210（2017）11（c）-0133-05

A Meta-analysis of the effect and safety of Lianhua Qingwen Capsules in the treatment of community acquired pneumonia

ZHOU Zhen WANG Sumei LIU Yanping

Department of Respiratory Medicine， the 174th Hospital of PLA， Fujian Province， Xiamen 361003， China

[Abstract] Objective To evaluate the efficacy and safety of Lianhua Qingwen Capsules in the treatment of community acquired pneumonia. Methods Medline， The Cochrane Libary， PubMed， Wanfang Database， VIP database， CNKI and CBM were searched to collect the randomized controlled trials on Lianhua Qingwen Capsule combined with conventional western medicine therapy in treating community acquired pneumonia from built library to December 2016. The studies were screened according to the inclusion and exclusion criteria， the quality of the literature was evaluated by reference to the Jadad score method， and Meta-analysis was performed by Rev Man 5.3 software. Results A total of 6 randomized controlled trials were included. The effective rate of combined treatment with Lianhua Qingwen Capsule was significantly higher than that of western medicine treatment alone （OR = 1.70， 95%CI： 1.15-2.52， P=0.008）， the antipyretic time （WMD = -2.33， 95%CI： -2.52 - -2.13， P < 0.00 001）， cough alleviated time （WMD = -2.63，95%CI： -2.84 - -2.41， P < 0.00001）， imaging outcome time （WMD = -1.95，95%CI： -2.73 - -1.18， P < 0.00 001） were significantly shorter than those of western medicine treatment alone， the difference between the two groups were statistically significant. Two studies reported adverse reactions， and there was no statistically significant difference between the combined treatment with Lianhua Qingwen Capsules and the treatment of western medicine alone （P > 0.05）. Conclusion Lianhua Qingwen Capsules combined treatment for patients with community acquired pneumonia can improve the effective rate， shorten the time of symptom relief， image outcome， less adverse reactions， and has a good adjuvant effect on community acquired pneumonia. Due to the quality and quantity of the literature， the above conclusions still need to expand the sample size， select the high quality literature for further verification.endprint

[Key words] Lianhua Qingwen Capsules； Community acquired pneumonia； Systematic review； Meta-analysis

社區獲得性肺炎是臨床的常見病，多發病，為外界病原體入侵刺激機體誘發的嚴重炎性反應，其是世界范圍內的重要致死性感染性疾病之一[1-2]。其臨床治療多以抗感染為主，主要依賴于抗菌藥物的運用[3]。近年來，疾病發病率呈現上升趨勢，疾病病原菌的耐藥性亦有所提高，使臨床疾病的治療遇到瓶頸[4]。伴隨祖國醫學的不斷革新發展，中醫藥輔助治療肺炎的功效日益受到重視。連花清瘟膠囊是一種以“清瘟解毒，宣肺泄熱”為主要功效的中成藥，在呼吸道感染的治療中起到重要作用，已有大量研究報道其治療上呼吸道感染的效果，系統評價也報道其療效肯定[5-7]?！?br>