A Network Meta-analysis On The Effect Of Hand Foot And Mouth Disease With Four Kinds Of Traditional Chinese Medicine Injection In Children

Objective:To estimate the effect and security of four kinds of traditional Chinese medicine injection,including xiyanping,reduning,yanhuning,tanreqing versus ribavirin injection in children of hand foot and mouth disease.Then comparison and sorting of advantages and disadvantages about these four kinds of traditional Chinese medicine injection in children of hand foot and mouth disease.Methods:Search through the network including PubMed,CNKI and Wan fang database were searched from its establishment to February 2018.Respectively to collect randomized controlled trials describing the use of four kinds of traditional Chinese medicine injection,including xiyanping,reduning,yanhuning and tanreqing separate contrast ribavirin injection in children of Hand foot and mouth disease and the related literature.Supplement the relevant literature by Google Scholar and other academic websites.Finally,the qualified documents were meta-analyses performed by RevMan5.3,and use ADDIS software to network meta-analyses of the four kinds of traditional Chinese medicine injection.Results:1213 literatures were retrieved,405 literatures about xiyanping injection,286 literatures about reduning injection,322 literatures about yanhuning injection,200 literatures about tanreqing injection,screening through the inclusion and exclusion criteria,finally,38 eligible RCT literatures were included.There are 8eligible RCT literatures were included 920 patients about xiyanping injection,15 eligible RCT literatures were included 2078 patients about reduning injection,6eligible RCT literatures were included 752 patients about yanhuning injection,also have 9 eligible RCT literatures were included 1212 patients about tanreqing injection.The results of meta-analysis show that the experimental group is better than the control group of total effective rate [OR=4.95,95%CI(4.03,6.09),P<0.00001],the experimental group is shorter than the control group of total course time of disease[WMD=-2.14,95%CI(-2.31,-1.96),P<0.00001],the experimental group is shorter than the control group of antipyretic time[WMD=-1.26,95%CI(-1.31,-1.21),P<0.00001] and the experimental group is shorter than the control group of recede time of rash and herpes [WMD=-1.72,95%CI(-1.94,-1.51),P<0.00001].At the same time,the results of network meta-analysis show that total effective rate: reduning injection>yanhuning injection>tanreqing injection>xiyanping injection,shortening the effect of total course time of disease: reduning injection>xiyanping injection>tanreqing injection,shortening the effect of antipyretic time: yanhuning injection>xiyanping injection>reduning injection=tanreqing injection and shortening the effect of recede time of rash and herpes: yanhuning injection>xiyanping injection.Conclusions:If we use traditional Chinese medicine injection to the hand foot and mouth disease of children can improve the efficiency better than the ribavirin injection.In the four kinds of traditional Chinese medicine injection,the effect of reduning injection is the best to improve the total effective rate and shorten the total course time of disease,the effect of yanhuning injection is the best to shorten the effect of antipyretic time and recede time of rash and herpes of disease.However,still need to carry out a large sample of high-quality randomized clinical trials to be confirmed.