Evaluation and Meta Analysis of Xiyanping and Ribavir in Treatment of Hand-Foot-and-Mouth Disease

Abstract:

Objective: To systematically appraise the effect and the safety of Xiyanping and Ribavirin in treatment of hand-foot-and-mouth disease (HFMD). Method: To search the reports about randomized controlled trials of Xiyanping, and evaluate the researching quality. Then the Meta analysis will be carried out for those reports satisfying some criteria. Result: 10 randomized controlled trials, which were equal or excess than 3 Jadad scores, were included into the systematic review. A Meta-analysis showed that the combination of Xiyanping and routine treatment had better efficacy on both overall clinical manifestations and diadynamic criteria than the Ribavirin monotherapy. The odds ratio (OR) and 95% confidence interval (95% CI) from the comparison of the improvement on overall clinical manifestations were 3.01 and 2.41-4.23 respectively. The results of improving levels of fever clearance time, deflorescence time and oral herpes subside time were the following:WMD=-0.85, 95%CI (from-0.99 to-0.71), P<0.000 01;WMD=-1.65, 95%CI (from-1.82 to-1.47), P<0.000 01 and WMD=-0.87, 95%CI (from-1.03 to-0.71), P<0.000 01, respectively. The OR and 95% CI of comparison of the incidence of ADR were 0.39 and 0.19-0.78 respectively. Conclusion: The combination of Xiyanping and routine treatment may have better effectiveness and safety for HFMD than the Ribavirin treatment had. Nevertheless, because of the unclear methodological quality of the included studies, the results of our Meta-analysis may possibly be of much bias. Further well-designed clinical studies are required for the evaluation of Xiyanping for the treatment of HFMD.