中成药治疗儿童肺炎支原体肺炎系统评价再评价

Evidence quality assessment of Chinese patent medicine in the treatment of mycoplasma pneumonia in children： An overview of systematic reviews and Meta-analyses

关键词:  肺炎支原体肺炎  中成药  儿童  GRADE  PRISMA 2020  ROBIS  AMSTAR 2  再评价

Key words:  mycoplasma pneumonia  Chinese patent medicine  children  GRADE  PRISMA 2020  ROBIS  AMSTAR 2  reassessment

摘要:

[目的] 对中成药治疗儿童肺炎支原体肺炎的系统评价/Meta分析进行再评价，为临床实践提供参考，推动中医药干预循证证据质量的提升。[方法] 系统检索中国知网、Cochrane Library等8个中、英文数据库，搜集涉及中成药治疗儿童肺炎支原体肺炎的系统评价/Meta分析，检索时间范围是从每个数据库建立到2023年10月30日。分别由2名成员独立筛选文献、提取资料，并采用PRISMA 2020进行报告质量评价、AMSTAR 2量表进行文献方法学质量评价、GRADE证据分级工具进行文献证据质量评价、ROBIS量表进行偏倚风险评估以及疗效评价。[结果] 共纳入11项研究，包含7种中成药。PRISMA 2020评分为12.5～25.0分，平均分为18.86分；AMSTAR 2评价结果显示有9个条目报告相对完整，关键条目报告中缺失较大的有2条；ROBIS评价工具显示仅2项研究为低风险，其余研究均存在不同程度的偏倚，总体质量不高。GRADE评价结果显示，纳入研究的证据质量为中等到极低。[结论] 现有证据表明，中成药联合西药治疗儿童肺炎支原体肺炎的疗效可能优于单用西药组，但多数研究的报告质量存在缺陷，方法学质量及证据质量普遍较低，且大部分研究的偏倚风险较高，这表明其文献质量较差，结果可信度较低，未来仍需更多高质量的系统评价/Meta分析为中成药治疗的有效性和安全性提供可靠、准确的证据支持。

Abstract:

[Objective] This study reevaluated the systematic evaluation/Meta-analysis of Chinese patent medicine for the treatment of pediatric mycoplasma pneumonia，to provide a reference for clinical practice and to promote the improvement of the quality of evidence-based evidence for Chinese medicine interventions. [Methods] A systematic search was performed in eight Chinese and English databases，including CNKI and Cochrane Library，collecting systematic reviews and meta-analyses related to Chinese patent medicine in the treatment of mycoplasma pneumonia in children. The search period was ranging from the establishment of each database to October 30，2023. Two reviewers independently screened literature，extracted data，and utilized the PRISMA 2020 for reporting quality assessment，AMSTAR 2 for methodological quality evaluation，GRADE evidence grading for evidence quality assessment，and ROBIS for bias risk assessment and efficacy evaluation. [Results] AA total of 11 studies were included，encompassing 7 types of Chinese patent medicine. The scores of PRISMA 2020 ranged from 12.5 to 25.0，with an average of 18.86. The evaluation of AMSTAR 2 indicated that 9 items were complete in all items and 2 items had large missing in key items. The evaluation of ROBIS indicated 2 studies at low risk，whi.the rest exhibited varying degrees of bias，resulting in overall suboptimal quality. GRADE assessment revealed evidence quality of included studies ranging from moderate to knockdown. [Conclusion] Current evidence suggests that the efficacy of Chinese patent medicine combined with Western medicines in the treatment of pediatric mycoplasma pneumonia may be better than that of the Western medicine group alone，but the quality of reporting of most studies is flawed，the methodological quality and quality of evidence are generally low，and most of the studies have a high risk of bias，which suggests that they have a poor quality of literature and low credibility of the results，and in the future，there is still a need for more high-quality systematic evaluations/Meta analyses to provide reliable and accurate evidence support for Chinese patent medicine treatment’s effectiveness and safety with reliable and accurate evidence support.