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目的：基于网状meta分析对不同中药汤剂治疗成人重症肺炎的疗效进行评价。方法：计算机检索中国知网（CNKI）、维普（VIP）、万方（Wangfang）、Cochrane Library、 Embase、PubMed、Web of science数据库。搜集数据库建库至2023年7月31日有关中药汤剂治疗成人重症肺炎的随机对照试验（randomized controlled trial,RCT）。采用Cochrane偏倚风险评价工具评估纳入文献的质量，应用Stata17.0软件基于频率学框架进行网状Meta分析。结果：最终纳入40项RCTs，涉及13种中药，3 773例患者。网状Meta分析结果显示，麻杏石甘汤合千金苇茎汤加减+西医常规在改善临床疗效方面可能是最有效的干预措施，清肺通腑汤加减+西医常规在在改善CRP方面可能是最有效的，清金化痰汤+西医常规在改善IL-6、TNF-α方面可能是最有效的，麻杏石甘汤加减加减+西医常规在改善PCT方面可能是最有效的，宣白承气汤加减+西医常规在改善APACHEⅡ、CPIS方面可能是最有效的。结论：中药汤剂联合西医常规治疗成人重症肺炎的疗效优于西医常规治疗且不良反应少。但受限于纳入文献质量及数目，上述结论仍需进一步验证。
Abstract：Objective:Based on network meta-analysis, the efficacy of different Chinese herbal decoction in the treatment of adult severe pneumonia was evaluated. Methods:Computer search of CNKI, VIP, Wangfang, Cochrane Library, Embase, PubMed, Web of science databases.randomized controlled trials(RCT) on TCM decoction for severe pneumonia in adults were collected up to July 31, 2023.The Cochrane bias risk assessment tool was used to assess the quality of the included literature, and Stata17.0 software was used to perform a network meta-analysis based on the frequency framework. Results:Finally, 40 RCTs were included, involving 13 traditional Chinese medicines and 3 773 patients.The results of network meta-analysis showed that Maxingshigan Decoction combined with QianjinWeijian Decoction + Western medicine routine may be the most effective intervention in improving clinical efficacy, QingfeiTongfu Decoction + Western medicine routine may be the most effective in improving CRP, QingjinHuatan decoction + Western medicine routine may be the most effective in improving IL-6 and TNF-α.Maxingshigan Decoction + Western medicine routine may be the most effective in improving PCT, Xuanbai Chengqi decoction + Western medicine routine may be the most effective in improving APACHE II and CPIS. Conclusion:The curative effect of TCM decoction combined with conventional western medicine on adult severe pneumonia is better than that of conventional Western medicine and the adverse reaction is less.However,limited by the quality and number of included literatures,the above conclusions still need to be further verified.
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基本信息:
DOI：10.13210/j.cnki.jhmu.20230907.001
中图分类号:R259
引用信息:
[1]王晓锦,李争,李风森.中药汤剂治疗成人重症肺炎疗效的网状Meta分析[J].海南医学院学报,2024,30(13):1002-1018.DOI:10.13210/j.cnki.jhmu.20230907.001.
基金信息:
新疆公共卫生关键技术研发与防疫体系建设（2020A03004）~~
2023-09-07
2023-09-07
2023-09-07