用乙氨基和布洛芬治疗发烧的短期双疗法或单疗法:一个网络元分析
Juan E De la Cruz-Mena1,2, Areti-Angeliki Veroniki3,4, Jorge Acosta-Reyes1
1Department of Public Health, Universidad del Norte, Barranquilla, Colombia.
Pediatrics
|September 25, 2024
概括
在儿童中,双重降热疗法 (乙胺和布洛芬) 可能比单次治疗更有效. 结合或交替的乙氨基和布洛芬在六小时内降低发烧,优于单独的乙氨基.
科学领域:
- 儿科药理学 儿科药理学
- 基于证据的医学是基于证据的医学.
- 临床试验分析临床试验分析
背景情况:
- 关于乙氨基和布洛芬作为单剂或双剂 (交替或联合) 降热疗法在儿童中的比较疗效和安全性存在不确定性.
- 了解最佳的抗发热策略对于有效的儿科发烧管理至关重要.
研究的目的:
- 进行系统性审查和网络元分析,比较乙氨基,单独布洛芬,交替和联合疗法对儿科发烧的疗效.
- 评估不同抗热疗法在降低儿童发烧方面的比较有效性.
主要方法:
- 在2023年9月20日之前,对Medline,Embase和CENTRAL数据库进行系统搜索.
- 包括随机试验,比较亚美诺芬,易布洛芬,交替和联合疗法在儿童发烧.
- 双向和网络元分析使用随机效应模型进行,由两名审稿人独立提取数据并进行偏差风险评估.
主要成果:
- 分析了31项涉及5009名儿童的试验.
- 结合疗法和交替疗法在4小时和6小时达到无发烧状态方面表现出优于单独使用乙氨基的优势.
- 虽然高剂量的布洛芬在4小时后显示出与乙氨基相似的疗效,但乙氨基在这个时间点下劣于单独的布洛芬;然而,在6小时后它们是相似的. 在治疗组之间没有观察到不良事件的显著差异.
结论:
- 双重抗发烧疗法 (替代性或组合性乙氨基和布洛芬) 似乎比单一药物疗法更有效,可以在前六小时内降低儿童的发烧.
- 单独治疗乙氨基可能比组合或交替策略效果更差,并且在短期内可能比单独治疗布洛芬效果更差.
- 可能需要进一步的研究来评估长期的疗效和安全性.
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