中医药治疗小儿慢鼻渊效的Meta-分析.docVIP

中医药治疗小儿慢鼻渊疗效的Meta-分析* 徐献梅1, 杨亮 （1. 贵阳中医学院第二附属医院, 贵阳市 550001No. 2 Hospital Affiliated to T.C.M. College of Guiyang, Guiyang 550001) ABSTRACT objective: To assess the efficacy of T.C.M. therapy for pediatric chronic sinusitis. Methods: Relevant literatures were reviewed via database and assessed via randomized controlled trial (RCT) scale. All reviewed literatures were assessed via Improved Jadad quality scale. Data statistical analyses were performed by RevMan 5.2.1 software. RESULTS: Six pieces of collected articles of RCT were evaluated (including 1114 patients). The test for heterogeneity: P = 0.58, indicating these 6 data had homogeneity, so we applied the fixed effect model. OR = 5.59, 95%CI (3.62, 8.61); Z = 7.79 (P0.00001). The T.C.M. therapy were better than the western medicine in treating pediatric chronic sinusitis. Conclusion: The T.C.M. therapy is possibly effective for pediatric chronic sinusitis. However, because of lower methodological quality of all the trials, the conclusions need to be interpreted cautiously, and more well designed and high quality RCTs need to be performed. KEY WORDS：Pediatric chronic sinusitis; Pediatric chronic sinusitis;T.C.M. therapy; Systematic review; Meta-analysis 慢性鼻窦炎（Chronic nasosinusitis）临属于中医学“慢鼻渊”的范畴，《素问·气厥论篇》曰：“胆移热于脑，则辛頞鼻渊。鼻渊者，浊涕不止也。”本病一年四季皆可发病，且多见于少年儿童。发病后常因患儿有鼻塞，头昏，头痛，腹胀，纳呆等症状而严重影响生长发育[1]。近年来，中医药在小儿慢性鼻窦炎的治疗过程中显示了独特的优势，但目前尚未见相关系统评价研究。本研究旨在对国内外公开发表的中医药治疗小儿慢鼻渊相关文献，进行荟萃分析，以评估其疗效和安全性，希冀为小儿慢鼻渊的中医药治疗提供实证依据。 1 资料与方法 1.1 纳入与排除标准 1.1.1纳入标准 ①确证的小儿慢鼻渊患者，诊断符合《中医耳鼻咽喉科学》[1]；②纳入试验组仅用中医内治法治疗小儿慢鼻渊（包括口服中药汤剂或中成药）的随机对照试验，对照组仅接受西药或安慰剂治疗，无论是否使用盲法，其治疗开始的时间、疗程、剂量不限；③疗效评价指标，总有效率等。 1.1.2 排除标准 排除试验组为中西医联合用药的干预；对照组是单用中药或单用针灸或中药联合西药等；无对照组的文献；数据不足无法利用的文献；重复发表的文献；实验研究等非临床治疗性文献；综述、经验总结、理论、探讨、个案报道等类型的文献。 1.2 文献检索 以“慢性鼻窦炎AND小儿、慢性鼻窦炎AND儿童、鼻渊AND小儿、鼻渊AND儿童、pediatric chronic sinusitis”为主题词计算机检索中国生物医学文献数据库、中文科技期刊数据库、中国期刊全文数据库；同时检索Cochrane Lib中Cochrane系统评价资料库以及美美国国立医学图书馆Pubmed数据库收录的文献；手工检索相关中文期刊、相关会议记录及所获文献的参考文献。文献语种为中文或英文。所有数据库均检索至2012年1