目的 系統(tǒng)評價5種清熱解毒類中成藥（抗感顆粒、板藍根顆粒、連花清瘟顆粒、小兒牛黃清心散或小兒豉翹清熱顆粒）聯(lián)合奧司他韋治療小兒流感的有效性和安全性，為臨床治療的選擇提供依據(jù)。方法 檢索中國學術期刊全文數(shù)據(jù)庫（CNKI）、中國生物醫(yī)學文獻數(shù)據(jù)庫（CBM）、萬方數(shù)據(jù)知識服務平臺（Wanfang Data）、維普期刊中文數(shù)據(jù)庫（VIP）、PubMed和Cochrane Library等中英文數(shù)據(jù)庫，檢索時間為建庫至2021年1月。篩選清熱解毒中成藥聯(lián)合奧司他韋（聯(lián)合用藥）對比奧司他韋單藥治療小兒流感的隨機對照試驗（RCT），采用RevMan 5.3軟件進行Meta分析。結果 共納入文獻24篇RCTs，包含患兒2 932名，聯(lián)合用藥較奧司他韋單藥治療小兒流感可以減少發(fā)熱緩解時間［MD=-20.37，95% CI=（-26.32，-14.43），P<0.05］和咳嗽緩解時間［MD=-20.45，95% CI=（-29.80，-11.10），P<0.05］，增加C反應蛋白（CRP）下降值［MD=5.72，95% CI=（2.58，8.86），P<0.05］，提高總有效率［RR=1.17，95% CI=（1.14，1.20），P<0.05］，同時可以減少惡心嘔吐［OR=0.44，95% CI=（0.24，0.80），P<0.05］和腹痛［OR=0.32，95% CI=（0.12，0.85），P=0.02］。結論 奧司他韋聯(lián)合清熱解毒類中成藥治療小兒流感可以減少發(fā)熱緩解時間和咳嗽緩解時間，增加CRP下降值，提高總有效率，同時減少惡心嘔吐和腹痛不良反應。但研究納入例數(shù)有限、文獻質量較低，需要設計嚴謹?shù)亩嘀行呐R床RCT增加論證強度。

Objective To systematically evaluate the efficacy and safety of five kinds of Qingrejiedu Chinese medicine (Kanggan Granules, Ban-Lan-Gen Granules, Lianhua Qingwen Granules, Xiaoer Niuhuang Qingxin Powder and Xiaoer Chiqiao Qingre Granules) combined with oseltamivir versus oseltamivir on treatment of influenza in children, and to provide reference for clinical treatment. Methods Computer searches of CNKI, CBM, WanFang, VIP, PubMed and Cochrane Library were conducted to collect randomized controlled trials (RCTS) on one of five kinds of Qingrejiedu Chinese medicine combined with oseltamivir versus oseltamivir on treatment of pediatric influenza. The time limit for retrieval is from the establishment of the database to January 2021. Meta-analysis was conducted by using RevMan 5.3 statistical software. Results A total of 24 RCTs were included,involving 2 932 children with flu. Results of meta-analysis showed that oseltamivir combined with qingrejiedu Chinese medicine can reduce the duration of fever [MD = -20.37, 95%CI = (-26.32, -14.43), P < 0.05] and cough [MD = -20.45, 95%CI = (-29.80, -11.10), P < 0.05], increase in CRP decline [MD = 5.72, 95%CI = (2.58, 8.86), P < 0.05], versus oseltamivir on treatment of pediatric influenza. What's more, it can increase effective rate [RR = 1.17, 95%CI = (1.14, 1.20), P < 0.05] while reducing the adverse reactions of nausea [OR = 0.44, 95%CI = (0.24, 0.80), P < 0.05] and stomachache [OR = 0.32, 95%CI = (0.12, 0.85), P = 0.02]. Conclusion Oseltamivir combined with qingrejiedu Chinese medicine on treatment of influenza in children can reduce the duration of fever and cough, increase in CRP decline and effective rate while reduce the adverse reactions of nausea and stomachache. But cases of study were limited and the quality of the literature is low, and more rigorously designed multi-center clinical randomized controlled trials are necessary to strengthen the argumentation.

河北省2020年度醫(yī)學科學研究課題計劃資助項目（20200978）