ObjectiveTo systematically review the efficacy and safety of ibuprofen for premature infants with patent ductus arteriosus. MethodsDatabases including PubMed, Ovid-EMbase, The Cochrane Library (Issue 11, 2014), CNKI, WanFang Data and VIP were searched to collect randomized controlled trials (RCTs) and quasi-RCTs about ibuprofen for premature infants with patent ductus arteriosus from inception to December 2014. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was conducted by RevMan 5.3 software. ResultsA total of 37 RCTs, involving 2 370 patients were included. The results of meta-analysis showed that, compared with the placebo/blank group, ibuprofen could increase the closure rate of PDA (LBWI:RR=1.93, 95%CI 1.25 to 2.99，P=0.003; VLBW:RR=1.23, 95%CI 1.02 to 1.48, P=0.03; ELBWI:RR=2.86, 95%CI 1.51 to 5.41, P=0.001) and decrease the incidence of sepsis (VLBW:RR=0.21, 95%CI 0.07 to 0.64，P=0.006); Compared with the indometacin groups, ibuprofen could decrease the incidence of the increase of serum creatinine (LBWI:RR=0.11, 95%CI 0.04 to 0.37, P=0.000 2), NEC (LBWI, RR=0.52, 95%CI 0.29 to 0.95, P=0.03) and oliguria (LBWI: RR=0.30, 95%CI 0.16 to 0.56, P=0.000 2; VLBW:RR=1.40, 95%CI 1.03 to 1.92, P=0.03); Compared with the intravenous ibuprofen, Oral ibuprofen could increase the closure rate of PDA (VLBW: RR=1.35, 95%CI 1.12 to 1.62, P=0.002; ELBWI, RR=1.42, 95%CI 1.07 to 1.87, P=0.01). ConclusionCurrent evidence shows that there is not indeterminate between ibuprofen and paracetamol groups. Compared with other general drugs, ibuprofen has an advantage over curing PDA and obviously reduces side effects. Due to the limited quality and quantity of included studies, more high quality studies are needed to verify the above conclusion.
Objective To assess the effectiveness of acupunctures in treatment of primary dysmenorrhea by using network meta-analysis. Methods Databases including the PubMed, EMbase, The Cochrane Library (Issue 6, 2016), CBM, CNKI and WanFang Data were searched for relevant clinical randomized controlled trials (RCTs) comparing acupunctures with ibuprofen or other kinds of acupuncture from inception to July 6th 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed by using Stata 13.0 and WinBugs 1.43 software. Results A total of 56 RCTs involving 4 600 PD patients were included. The results of network meta-analysis showed that: for the clinical effects: simple acupuncture, acupuncture plus moxa-moxibustion, acupuncture plus indirect-moxibustion, electroacupuncture, warm-acupuncture and electroacupuncture plus warm-acupuncture were superior to ibuprofen, acupuncture plus moxa-moxibustion, acupuncture plus indirect-moxibustion and warm-acupuncture were superior to simple acupuncture. For VAS score, there was no significant difference among all treatments. Simple acupuncture and ibuprofen were superior to acupuncture plus indirect-moxibustion in dysmenorrhea symptom scores. Conclusion The included 6 kinds of acupunctures are superior to ibuprofen and different acupunctures have different advantages in the treatment of PD. When selecting treatment regimen, it is better to consider the clinical situation and TCM syndrome differentiation.