清瘟败毒饮联合西医常规治疗脓毒症有效性与安全性的Meta分析*

作者：顾 晔，徐兴凯，周 想，胡柏生，王道才，潘青青，陈海龙

单位：上海市宝山区中西医结合医院，上海 201900

引用：引用：顾晔，徐兴凯，周想，胡柏生，王道才，潘青青，陈海龙.清瘟败毒饮联合西医常规治疗脓毒症有效性与安全性的Meta分析[J].中医药导报,2026,32(5):220-226,260.

DOI：10.13862/j.cn43-1446/r.2026.05.034

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摘要：

目的：通过Meta分析，评估清瘟败毒饮在脓毒症治疗中的有效性和安全性。方法：检索中国知网、万方数据知识服务平台、维普中文期刊服务平台、PubMed、Embase、Cochrane Library及Web of Science等中英文数据库，收集自建库至2025年5月31日发表的关于清瘟败毒饮联合西医常规治疗脓毒症的随机对照试验（RCT）。文献筛选、数据提取及质量评价由两名研究者独立完成，并使用Cochrane偏倚风险评估工具对纳入文献进行方法学质量评价。采用RevMan 5.4软件进行Meta分析。结果：纳入23篇RCT，样本总量1 592例。相较于联合常规西药治疗，联合清瘟败毒饮可显著提高疗效，改善临床总有效率[RR=1.20，95%CI（1.13，1，28），Z=5.54，P＜0.000 01]、中医证候积分[MD=-2.24，95%CI（-2.84，-1.64），Z=7.34，P<0.000 01]、APACHEⅡ评分[MD=-3.31，95%CI（-4.03，-2.60），Z=9.05，P<0.000 01]，并显著降低炎症因子CRP[MD=-9.16，95%CI（-14.04，-4.28），Z=3.68，P=0.000 2]、IL-1[MD=-20.76，95%CI（-24.30，-17.23），Z=11.51，P<0.000 01]、IL-6[MD=-10.56，95%CI（-12.38，-8.74），Z=11.36，P<0.000 01]、TNF-α[MD=-17.35，95%CI（-25.78，-8.92），Z=4.04，P<0.000 01]和PCT[MD=-2.52，95%CI（-3.14，-1.90），Z=7.98，P<0.000 01]。结论：清瘟败毒饮的疗效可能与其抑制炎症因子和免疫调节作用相关。该方在脓毒症治疗中的应用为临床提供了循证支持，但仍需更高质量的临床研究进一步验证。

关键词：清瘟败毒饮；脓毒症；系统评价；Meta分析

Abstract：

Objective: To evaluate the efficacy and safety of Qingwen Baidu Decoction in the treatment of sepsis through Meta-analysis. Methods: Chinese and english databases including China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform (Wanfang Data), China Science and Technology Journal Database (CSTJ), PubMed, Embase, Cochrane Library and Web of Science were searched to collect randomized controlled trials (RCTs) on Qingwen Baidu Decoction combined with western medicine for sepsis published from the establishment of the databases to May 31, 2025. Literature screening, data extraction and quality assessment were completed independently by two researchers, and the methodological quality of included studies was evaluated using the Cochrane risk-of-bias tool. Meta-analysis was performed using RevMan 5.4 software. Results: A total of 23 RCTs were included, with a total sample size of 1,592 patients. Compared with conventional western medicine alone, combined Qingwen Baidu Decoction significantly improved the total clinical effective rate [RR=1.20, 95%CI(1.13, 1.28), Z=5.54, P<0.000 01], traditional Chinese medicine syndrome score [MD=-2.24, 95%CI(-2.84, -1.64), Z=7.34, P<0.000 01], and APACHE Ⅱ score [MD=-3.31, 95%CI(-4.03, -2.60), Z=9.05, P<0.000 01]. It also significantly reduced inflammatory factors including CRP [MD=-9.16, 95%CI(-14.04, -4.28), Z=3.68, P=0.000 2], IL-1 [MD=-20.76, 95%CI(-24.30, -17.23), Z=11.51, P<0.000 01], IL-6 [MD=-10.56, 95%CI(-12.38, -8.74), Z=11.36, P<0.000 01], TNF-α [MD=-17.35, 95%CI(-25.78, -8.92), Z=4.04, P<0.000 01] and PCT [MD=-2.52, 95%CI(-3.14, -1.90), Z=7.98, P<0.000 01]. Conclusion: The therapeutic effects of Qingwen Baidu Decoction may be related to its inhibitory effect on inflammatory factors and immunomodulatory action. The application of this formula in sepsis treatment provides evidence-based support for clinical practice, but further high-quality clinical studies are needed for validation.

Key words：Qingwen Baidu Decoction; sepsis; systematic review; Meta-analysis

发布时间：2026-05-24

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