论著

放血疗法治疗小儿发热的 meta 分析

Efficacy of bloodletting therapy in the treatment of pediatric fever:A meta-analysis

:299-307
 
    目的   探讨放血疗法对小儿发热的疗效。方法   检索包括中国生物医学文献数据库(CBM)、CNKI、万方、维普、PubMed、Embase、Web of Science、Cochrane Library等8个中、英文数据库自建库至2025年5月所发表的放血疗法治疗小儿发热的随机对照试验研究(RCT),2名研究人员根据Cochrane系统评价手册(5.1.0版)推荐的偏倚风险评估表对所纳入文献进行质量评估,采用RevMan 5.4软件对纳入文献质量进行系统分析。结果  纳入19项RCT,共2 224例患儿,其中观察组1 118例、对照组1 106例。放血疗法能够提高小儿发热的临床疗效[OR=4.18,95% CI(3.00,5.38),P<0.001];降低患儿24 h内高热复发率[OR=0.12,95% CI(0.05,0.34),P<0.001];缩短平均退热时间[MD=-1.78,95% CI(-2.56,-1.00),P<0.001]。结论  放血疗法能够提高小儿发热的临床疗效,降低复发率,缩短退热时间,可作为小儿发热的辅助治疗方法。
       Objective  To explore the efficacy of bloodletting therapy treatment on pediatric fever by meta-analysis.Methods  The randomised controlled trials(RCTs)examining bloodletting therapy for paediatric fever were  retrieved from eight Chinese and English databases—China Biomedical Literature Database(CBM),CNKI,Wanfang,VIP,PubMed,Embase,Web of Science,and Cochrane Library—covering publications from the establishment of each database up to May 2025.Two researchers assessed study quality using the risk of bias assessment tool recommended in the Cochrane Handbook for Systematic Reviews(version 5.1.0).RevMan 5.4 software was employed for systematic analysis of included studies.Results  Nineteen RCTs involving 2 224 patients were ultimately included,comprising 1 118 patients in the observation group and 1 106 in the control group.Results indicated that bloodletting therapy significantly improved clinical efficacy in paediatric fever(OR=4.18,95% CI[3.00,5.38],P<0.001),reduced the recurrence rate of high fever within 24 hours(OR=0.12,95% CI[0.05,0.34],P<0.001),and shortened the average time to fever resolution(MD=-1.78,95% CI[-2.56,-1.00],P<0.001).Conclusions  Bloodletting therapy can improve the clinical efficacy of pediatric fever,reduce the recurrence rate and shorten the time of fever reduction,and can be used as an adjunctive treatment for pediatric fever.
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