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目的 评价中西医结合疗法的疗效。 方法 检索策略 :电子检索MEDLINE ,EMBASE ,和中国生物医学资料库 ;手工检索中文杂志和已发表相关文献的参考文献目录、INTERNET、会议论文集。资料的收集与分析 :三个评价者独立地收集提取资料。对具有同质性的资料进行Meta 分析。纳入研究 :中西医结合治疗SARS并与西医进行对照的随机对照试验和前瞻性对照研究。观察对象 :根据中国卫生部、世界卫生组织、美国疾病控制中心的SARS诊断标准确诊的SARS患者。干预措施 :治疗组采用中西医结合治疗 ,对照组单用西医治疗。主要测量指标 :①病死率 ;②由于使用激素引起的并发症发生率 ;③SARS病毒消除率 ,采用细胞培养和PCR检测 ;④退热时间 ;⑤胸片显示肺部炎症吸收时间和完全吸收例数 ;⑥下呼吸道感染症状消失时间 (咳嗽、呼咳困难、呼咳短促等 )。次要测量指标 :①激素累积剂量或平均使用时间 ;②T 淋巴细胞亚群计数 (CD3+ ,CD4 + ,CD5 + ,CD8+ )。 结果 纳入 9个研究 ,包括 812例患者 ,所有 9个研究都存在选择性偏倚、实施性偏倚、检测性偏倚的高可能性。以下指标中西医结合治疗与单纯西医治疗的差异有统计学意义 ,并优于单纯西医治疗 :病死率 [OR0 32 ,95 %CI (0 14 ,0 71) ],退热时间 [WMD - 1 17,95 %CI (- 1
Objective To evaluate the curative effect of integrated traditional Chinese and western medicine. Methods Search strategy: MEDLINE, EMBASE, and China Biomedical Database were searched electronically. The catalogs of references of Chinese magazines and published relevant papers were searched by hand, INTERNET and conference proceedings. Data collection and analysis: Three reviewers independently collected data. Meta-analysis of homogeneous data. Included in the study: Randomized controlled trials and prospective controlled studies comparing Chinese and Western medicine in the treatment of SARS with western medicine. Subjects: SARS patients diagnosed according to the SARS diagnostic criteria of the Chinese Ministry of Health, World Health Organization, and US Centers for Disease Control and Prevention. Interventions: The treatment group was treated with combination of TCM and Western medicine, while the control group was treated by Western medicine alone. The main measurement indicators: ① mortality; ② due to the use of hormones caused by the incidence of complications; ③ SARS virus elimination rate, using cell culture and PCR detection; ④ antipyretic time; ⑤ chest showed pulmonary inflammatory absorption time and the total number of cases of absorption ; ⑥ lower respiratory tract symptoms disappear time (cough, cough, difficulty cough, cough, etc.). Secondary measurement indicators: ① hormone cumulative dose or average use time; ② T lymphocyte subsets count (CD3 +, CD4 +, CD5 +, CD8 +). Results Nine studies, including 812 patients, were included in all 9 studies with the highest likelihood of selectivity bias, implementation bias, and detection bias. The following indicators of Integrative Medicine and Western medicine treatment were significantly different, and better than Western medicine alone: the mortality rate [OR0 32, 95% CI (0 14, 0 71)], antipyretic time [WMD - 1 17 , 95% CI (-1