Comparative Analysis Of Xiyanping Injection And Yanhuning Injection In The Treatment Of Pediatric Infectious Diseases

Objective:Using the meta analysis to evaluate the efficacy and safety of Xiyanping and Yanhuning in the treatment of infectious diseases in children.The cost-effectiveness method was used to evaluate the economics of Xiyanping and Yanhuning in the treatment of infectious diseases in children.All of that can provide a basis for clinical rational selection of drugs.Methods:Retrieve randomized controlled trials of Xiyanping and Yanhuning in the treatment of infectious diseases from China National knowledge Infrastructure,Wanfang Data knowledge service platform,Vip journal resources integrated service platform,Web of knowledge,Pubmed and Springerlink which were published from initial database to October 2018.Two reviewers screened the literature according to the inclusion criteria and exclusion criteria,extract information and cross-check screening.To evaluate the heterogeneity among the studies,we used chi-squared test(Q test)and I~2 test.P>0.10 and I~2<50%indicated no significant heterogeneity existed.In this case,fixed effect model was used.Otherwise,random effect model was applied.Sensitivity analysis was applied to explore the source of heterogeneity.Publication bias was evaluated by fuunel plot.All statistical analysis was performed using the Review Manager 5.3 software.P<0.05 was considered statistically significant.Results:A total of 23 studies were included,of which 2820 patients were included.This article briefly compares and analyzes the differences between the two drugs in the treatment of infectious diseases,and then focuses on the analysis of the differences in the treatment of pediatric system infections.The meta-analysis results of using Review Manager 5.3:The difference of the total effective rate between Xiyanping and Yanhuning injection in the treatment of infectious diseases was statistically significant(P<0.05);the difference of the obvious effective rate between the two drugs in the treatment of infectious diseases was not statistically significant(P>0.05);the difference of the adverse reaction rate between Xiyanping and Yanhuning injection in the treatment of infectious diseases was statistically significant(P<0.05).Sensitivity analysis of the three showed low sensitivity and high stability.Funnel plots was used to assess the publication bias.Visual assessment of funnel plots did not reveal evidence of significant asymmetry in this study.Subgroup analysis results:(1)The difference of the total effective rate between Xiyanping and Yanhuning injection in the treatment of children's infectious diseases was statistically significant(P<0.00001),and Xiyanping is better than Yanhuning;The publication bias analysis showed publication bias possibility is little.(2)The difference of the obvious effective rate between Xiyanping and Yanhuning injection in the treatment of children's infectious diseases was statistically significant(P<0.00001),and the obvious effective rate of Xiyanping is higher than Yanhuning;The publication bias analysis showed publication bias possibility is little.(3)The difference of the adverse reaction rate between Xiyanping and Yanhuning injection in the treatment of children's infectious diseases was statistically significant(P<0.00001),and the adverse reaction rate of Xiyanping is lower than Yanhuning.The publication bias analysis showed publication bias possibility is little.(4)The difference of the total effective rate between Xiyanping and Yanhuning injection in the treatment of pediatric respiratory(P<0.00001)and intestinal infections(P=0.03<0.05)was statistically significant.Xiyanping is better than Yanhuning in all of that.(5)The difference of the adverse reaction rate between Xiyanping and Yanhuning injection in the treatment of pediatric respiratory infections was statistically significant(P<0.00001),and the adverse reaction rate of Xiyanping is lower than Yanhuning;The adverse reaction rate of Xiyanping(1.43%)is lower than Yanhuning(2.14%)in the treatment of pediatric intestinal infections.The results showed that Xiyanping was better than Yanhuning in the treatment of infectious diseases and pediatric infectious diseases,the adverse reaction rate of Xiyanping is lower than Yanhuning in the two.The method of cost-effectiveness analysis used for pharmacoeconomic analysis,the result showed that the cost-effectiveness ratio(C/E)of Xiyanping(2.5)is higher than Yanhuning(1.4),and the sensitivity analysis showed stable results.Conclusion:The meta-analysis showed:Xiyanping and Yanhuning injections have statistically significant differences in the total effective rate,in the obviously effective rate and incidence of adverse reactions in the treatment of pediatric infectious diseases;Xiyanping is better than Yanhuning in the treatment of pediatric respiratory and intestinal infections;Cost-effect analysis showed that Xiyanping is better than Yanhuning in pharmacoeconomics.Incremental cost effect ratio(ICER)can't evaluate the results because of the lacking of boundary value in the sensitivity analysis.