| SARS is a global respiratory tract infectious disease threating people,s life seriously ,SARS-Cov is the pathogen causing this disease.The most common symptom in SARS patients is high fever (with a body temperature of >38℃),cough,arthralgia and myalgias,dyspnea,ARDS,moist rales of lungs and unilateral,patchy infiltrative shadowing or reticular changes to different extent in lungs.SARS has a strong infectivity,dangerous state of illness and high fatality rate,which hasn,t a valid therapeutic method by far,symptomatic and supportive therapy are mainly used now.Traditional Chinese medicine has a long history and precious clinical experiences in treating infectious disease as traditional medicine in our country,treatment of intergrative traditional Chinese medicine with western medicine (ICWM) responsed to SARS with rationality.More and more studies show that ICWM has a better effect in treating SARS compared with western medicine alone(WM),example for reducing fatality rate of SARS patients ,decreasing the mean fever time,accelerating the absorption of inflammation and so on;but the evidence supported by EBM is absent at present.EBM is the medicine abiding by evidence,it is defined that "The conscientious ,explicit,and judicious use of current best evidence in making decisions about the care of individual patients".EBM covers every medical field of diagnosis,therapy,prevention and so on,and provides reliable science evidence for scientific research of clinical medical treatment and decisions in medical hygiene.With regard to treatment of SARS,which has a strong infectivity and serious harm to peoples, s life,how to obtain a kind of treatment method with high effect ,little ill effect and low throwing of expense,therefore it is necessary to seek for the best therapeutecs program using methods of EBM.Meta-analysis is the capital rearch method of EBM.The objective of this study is to assess the effect of ICWM in treatment of SARS by using Meta-analysis on the basis of all-around literature collection and strict quality evaluation and provid the treatment regimen supported by EBM for SARS. We searched PubMed,CJFD,wangfang data,special topic web about SARS and handsearched conference papers using SARS and ICWM as key words.Eleven studies were included in my paper according to inclusion criteria.Jadad Scale was used to assess the quality of included studies,scores of five studies are 1～2,the rest ones are all 0. Forest plots and funnel plots were made by RevMan(a kind of software).Hetergeneity and bias of incluled studies were analyzed respectively and method of formula was used to evaluate publication bias quantitatively.Sensitivity analysis of results were performed among different effect sizes,among different effect models,among studies of different quality and between the result calculated manually and the one made by RevMan;The mean fever time ,average dose of corticosterid and fatality rate were pooled respectively by using WMD,SMD and OR,method of General Variance-Based,method of DerSimonian-Laird and method of Peto were carried out. Synthesized results are as follow, mean fever time:WMD -0.65,95%CI (-1.45, -0.15);average dose of corticosteroid:SMD -1.18,95%CI (-4.36,2.00); fatality rate OR 0.24 ,95%CI(0.13,0.43).No heterogeneity between the two studies for mean fever time was detected and the fatality rate also;but heterogeneity was detected in pooling analysis for average dose of corticosteroid and the heterogeneity was obvious.The funnel plot for average dose of corticosteroid was not symmetric,the rest two were symmetric on the... |
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