首页|痰热清注射液治疗老年重症肺炎的Meta分析与试验序贯分析

痰热清注射液治疗老年重症肺炎的Meta分析与试验序贯分析

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该研究旨在系统评价痰热清注射液治疗老年重症肺炎的有效性及安全性,检索中、英文数据库以及临床试验注册平台,纳入18篇随机对照试验(RCTs),涉及1 457例老年重症肺炎患者。采用Cochrane偏倚风险评估工具评价纳人文献的质量,采用RevMan 5。4及Stata 17软件进行Meta分析,采用TSA 0。9。5。10 beta软件进行试验序贯分析(TSA)。Meta分析结果显示,与常规西医治疗相比,痰热清注射液+常规西医能显著提高老年重症肺炎患者的临床有效率(RR=1。26,95%CI[1。20,1。32],P<0。000 01)、动脉血氧分压(SMD=6。23,95%CI[3。29,9。18],P<0。000 1)、氧合指数(SMD=11。72,95%CI[4。41,19。04],P=0。002),降低降钙素原(SMD=-6。16,95%C1[-8。10,-4。21],P<0。000 01)、C-反应蛋白(SMD=-8。50,95%CI[-11。05,-5。96],P<0。000 01)、白细胞计数(SMD=-4。56,95%CI[-5。73,-3。39],P<0。000 01),缩短发热时间(SMD=-3。12,95%CI[-4。61,-1。63],P<0。000 1)、咳嗽时间(SMD=-4。84,95%CI[-6。90,-2。79],P<0。000 01)、肺部啰音时间(SMD=-0。99,95%CI[-1。54,-0。44],P=0。000 4)、机械通气时间(SMD=-3。26,95%CI[-5。03,-1。50],P=0。000 3),提高 CD4+T 细胞水平(SMD=6。73,95%CI[5。23,8。23],P<0。000 01)、CD8+T 细胞水平(SMD=7。47,95%CI[5。32,9。61],P<0。000 01),且没有明显的不良反应。TSA证实临床有效率的结果具有稳定性和可靠性。结果表明,痰热清注射液作为一种中药制剂,对老年重症肺炎具有显著的治疗效果和良好的安全性。考虑纳人文献质量偏低,研究结论仍需更多高质量的RCT提供证据支持。
Meta-analysis and trial sequential analysis of Tanreqing Injection in treatment of severe pneumonia in elderly
This study aimed to systematically evaluate the effectiveness and safety of Tanreqing Injection in the treatment of severe pneumonia in the elderly.Eighteen randomized controlled trials(RCTs)involving 1 457 elderly patients with severe pneumonia were included in the study after conducting searches in both Chinese and English databases as well as clinical trial registration platforms.The quality of the included studies was assessed using the Cochrane risk of bias assessment tool.Meta-analysis were conducted using RevMan 5.4 and Stata 17 software,and trial sequential analysis(TSA)was performed using TSA 0.9.5.10 beta software.Meta-analysis results showed that compared with conventional western medicine treatment,Tanreqing Injection+conventional western medical significantly improved the clinical effectiveness in elderly patients with severe pneumonia(RR=1.26,95%CI[1.20,1.32],P<0.000 01),arterial oxygen partial pressure(SMD=6.23,95%CI[3.29,9.18],P<0.000 1),oxygenation index(SMD=11.72,95%CI[4.41,19.04],P=0.002),reduce procalcitonin(SMD=-6.16,95%CI[-8.10,-4.21],P<0.000 01),C-reactive protein(SMD=-8.50,95%CI[-11.05,-5.96],P<0.000 01),white blood cell count(SMD=-4.56,95%CI[-5.73,-3.39],P<0.000 01),and shortened the duration of fever(SMD=-3.12,95%CI[-4.61,-1.63],P<0.000 1),cough(SMD=-4.84,95%CI[-6.90,-2.79],P<0.000 01),lung rales(SMD=-0.99,95%CI[-1.54,-0.44],P=0.000 4),and mechanical ventilation time(SMD=-3.26,95%CI[-5.03,-1.50],P=0.000 3),increase CD4+T-cell levels(SMD=6.73,95%CI[5.23,8.23],P<0.000 01)and CD8+T-cell levels(SMD=7.47,95%CI[5.32,9.61],P<0.000 01)with no significant adverse reactions.TSA confirmed the stability and reliability of the results related to clinical effectiveness.This study suggests that Tanreqing Injection,as a Chinese medicinal preparation,has a significant therapeutic effect and good safety profile in the treatment of severe pneumonia in elderly patients.Due to the limited quality of the included studies,high-quality RCT is still needed to provide evidence support for the above conclusions.

Tanreqing Injectionsevere pneumonia in the elderlyMeta-analysistrial sequential analysis

姜艳辉、倪世豪、张先进、黄婕、刘浩辉、许露、廖慧丽、薛东升、杨忠奇

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广州中医药大学第一临床医学院,广东广州 510405

广州中医药大学第一附属医院,广东广州 510405

上海凯宝药业股份有限公司,上海 201401

痰热清注射液 老年重症肺炎 Meta分析 试验序贯分析

国家中医药局新型冠状病毒感染中医药应急专项(第二批)(2023)

2023ZYLCYJ02-17

2024

中国中药杂志
中国药学会

中国中药杂志

CSTPCD北大核心
影响因子:1.718
ISSN:1001-5302
年,卷(期):2024.49(4)
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