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目的:对中西医结合治疗免疫性血小板减少症(Immune thromobocytopenia,ITP)的疗效进行meta分析和评价,探索更加有效且低副反应的治疗儿童ITP的新方法。方法:应用计算机检索万方数据库(Wanfang Date)、中国学术期刊全文数据库(CNKI)、PubMed、中国生物医学文献数据库(CBM),对搜集到的临床随机对照试验进行方法学质量评估,采用RevMan5.3软件进行meta分析。结果:Meta分析结果显示:在有效方面:中药治疗优于激素治疗(OR:3.4595%CI[2.35,5.45]),差异具有统计学意义(P<0.05),中西医结合治疗优于激素治疗(OR:3.1295%CI[1.35,5.28]),差异具有统计学意义(P<0.05);在治愈方面:中药治疗优于激素治疗(OR:2.2595%CI[1.45,3.45]),差异具有统计学意义(P<0.05),中西医结合治疗优于激素治疗(OR:2.8495%CI[1.65,4.75]),差异具有统计学意义(P<0.05)。口服中药和中西医结合治疗儿童ITP效果均优于激素治疗。中西医结合治疗的治愈率和有效率均高于单独中药治疗,但对比差异均无统计学意义(P>0.05)。结论:口服中药的中西医结合治疗法在ITP的治疗过程中疗效显著,虽然与中药治疗效果无明显差异,但明显优于激素治疗法,值得进一步推广。
Objective: To evaluate the efficacy of traditional Chinese and western medicine in the treatment of Immune thrombobocytopenia (ITP) and to explore a new and more effective method for treating ITP in children with low side effects. Methods: Wanfang Date, CNKI, PubMed and CBM were searched by computer. The methodological quality of the randomized controlled clinical trials was evaluated using RevMan5. 3 software meta-analysis. Results: The results of Meta analysis showed that in the aspects of effective treatment, Chinese medicine treatment was superior to hormone therapy (OR: 3.4595% CI 2.35,5.45), the difference was statistically significant (P <0.05) OR: 3.1295% CI [1.35,5.28]), the difference was statistically significant (P <0.05); in the aspect of cure, Chinese medicine treatment was superior to hormone therapy (OR: 2.2595% CI 1.45,3.45), the difference was statistically significant (P <0.05). The combination of TCM and Western medicine was superior to hormone therapy (OR: 2.8495% CI 1.65,4.75), the difference was statistically significant (P <0.05). Oral Chinese medicine and Integrative Medicine ITP treatment in children are superior to hormone therapy. The cure rate and effective rate of integrated traditional Chinese and Western medicine treatment were higher than that of single Chinese medicine treatment, but the difference was not statistically significant (P> 0.05). Conclusion: Integrative Chinese and Western medicine treatment with oral traditional Chinese medicine has significant curative effect in the course of ITP treatment. Although there is no significant difference with traditional Chinese medicine treatment, it is obviously better than steroid therapy and worth to be further popularized.