Cochrane Database of Systematic ReviewsCochrane系统综述数据库
Cochrane Database of Systematic Reviews(英文缩写 COCHRANE DB SYST REV),ISSN 1469-493X,eISSN 1361-6137,中文译名:Cochrane系统综述数据库 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-11-01 至 2026-10-31，按本站收录文献的发表日期统计。
期刊介绍
历年影响因子趋势
| JCR 数据年份 | 影响因子 | JCR 分区 |
|---|---|---|
| 2021 | 11.874 | Q1 |
| 2022 | 8.400 | Q1 |
| 2023 | 8.800 | Q1 |
| 2024 | 9.400 | Q1 |
| 2025 | 11.100 | Q1 |
Cochrane Database of Systematic Reviews 最新收录文献
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1. Interventions for treatment of herpes labialis (cold sores on the lips).
1. 治疗唇疱疹（嘴唇上的冷疮）的干预措施PMID:日期:2026-09-30Herpes labialis (also known as cold sores or fever blisters) is a highly prevalent recurrent infection caused by the herpes simplex virus. Recurrences arise from varied triggers. Standard treatments usually involve nucleoside antivirals. Several studies have investigated alternative treatments such as zinc, honey, and photodynamic therapy for their potential to shorten lesion duration and relieve symptoms, but most reviews exclude these therapies. We wished to address this evidence gap by evaluating both conventional and alternative approaches, synthesising evidence on efficacy and safety to inform clinical practice and guide patient decisions. To assess the benefits and harms of interventions for treating herpes labialis in immunocompetent people. We searched CENTRAL, MEDLINE, and Embase on 23 September 2025, and we searched two clinical trial registries (ClinicalTrials.gov and World Health Organization International Clinical Trials Registry Platform) on 1 October 2025. We included randomised controlled trials (RCTs) enrolling immunocompetent people with herpes labialis. Eligible interventions included topical, oral, and physical therapies (e.g. nucleoside antivirals, anti-inflammatory agents, phototherapy, photodynamic therapy). Eligible comparators were placebo, no treatment, or another active intervention. We applied no restrictions related to publication language or status (published, unpublished, in press, or in progress). Our critical outcomes were healing time (with healing defined as loss of crusts or all symptoms), rated by participants or investigators; and any adverse events leading to treatment cessation. Our important outcomes were participant-rated improvement of signs and symptoms (e.g. global rate of change scales), change from baseline in clinical episode severity (e.g. lesion size), change from baseline in pain severity, and any mild or moderate adverse events not leading to treatment cessation. We assessed the risk of bias using the Cochrane RoB 2 tool. We synthesised outcomes descriptively and pooled data with a random-effects meta-analysis using the inverse-variance method where appropriate. We reported dichotomous outcomes as risk ratios (RRs), continuous outcomes as mean differences (MDs), and time-to-event data as hazard ratios (HRs), all with 95% confidence intervals (CIs). For rare outcomes, we calculated the Peto odds ratio (OR). We assessed heterogeneity using the I² statistic and performed subgroup analyses by intervention or dose. We also conducted sensitivity analyses, excluding trials with high risk of bias. We rated the certainty of evidence using the GRADE approach. We included 87 RCTs with 22,631 participants. Forty-two trials were conducted in multiple centres and 39 in a single centre (the remaining 6 trials did not report number of centres). Most participants were adults (≥ 18 years), though some trials also enrolled younger individuals. The trials covered 58 interventions: 37 topical, eight oral, and 12 other therapies. Forty-three trials were industry funded, 25 received funding from non-profit organisations, one received no funding, and 18 did not report funding sources. No studies in our main comparisons reported participant-rated improvement of signs and symptoms, change from baseline in clinical episode severity, or change from baseline in pain severity. Topical aciclovir versus placebo Topical aciclovir probably reduces healing time compared with placebo (MD -0.88 days, 95% CI -1.43 to -0.33; I = 74%; 7 studies, 3475 participants; moderate-certainty evidence). The risk of adverse events leading to treatment cessation and the risk of mild or moderate adverse events are probably similar with topical aciclovir and placebo. Topical penciclovir versus placebo Topical penciclovir probably reduces healing time compared with placebo (MD -1.20 days, 95% CI -1.80 to -0.60; 528 participants; moderate-certainty evidence). The risk of adverse events leading to treatment cessation and the risk of mild or moderate adverse events are probably similar with topical penciclovir and placebo. Oral aciclovir versus placebo Oral aciclovir may result in little to no difference in healing time compared with placebo (MD -0.86 days, 95% CI -2.02 to 0.3; 1 study, 145 participants; low-certainty evidence). No studies in this comparison reported data for adverse effects. Oral valaciclovir versus placebo Oral valaciclovir reduces healing time compared with placebo (MD -1.05 days, 95% CI -1.40 to -0.70; P < 0.001, I² = 0%; 2 studies, 1218 participants). The trials evaluating this comparison reported no adverse events leading to treatment cessation. The risk of mild or moderate adverse events is probably similar with oral valaciclovir and placebo. Topical penciclovir versus topical aciclovir Topical penciclovir and topical aciclovir may have similar effects on healing time (hazard ratio (HR) 0.88, 95% CI 0.67 to 1.16; 1 study, 225 participants; low-certainty evidence). The trial evaluating this comparison reported no adverse events leading to treatment cessation. The risk of mild or moderate adverse events may be similar with topical penciclovir and topical aciclovir. Topical aciclovir versus oral aciclovir No trials compared topical aciclovir with oral aciclovir. Compared with placebo, topical nucleoside antivirals (aciclovir and penciclovir) probably reduce cold sore healing time by about one day. A study that compared topical penciclovir with topical aciclovir found that they may have similar effects on healing time. For oral nucleoside antivirals, we found that oral aciclovir compared with placebo may have little or no effect on healing time, while oral valaciclovir reduces healing time by about one day. The clinical importance of all reported reductions in healing time is uncertain, as no minimally important difference has been defined for this outcome in herpes labialis. Severe adverse events were rare, and mild or moderate adverse events were uncommon. Adverse events were generally balanced between treatments. From an equity standpoint, most studies focused on adults, predominantly women, with limited East Asian and paediatric representation. Future research should address these gaps by including under-represented groups and standardising outcomes for robust comparisons. Developing core outcome sets for recurrent herpes labialis would enhance consistency, support evidence synthesis, and guide clinicians towards more effective, equitable treatments globally. This review had no dedicated funding. Protocol (2022) DOI: 10.1002/14651858.CD015216.
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2. Systemic azoles for asthma with fungal sensitisation.
2. 全身性唑类药物治疗伴有真菌致敏的哮喘PMID:日期:2026-09-30This is a protocol for a Cochrane review (intervention). The objectives are as follows: To assess the effects of adding systemic azoles to standard asthma care for people with asthma who have evidence of fungal sensitisation (including severe asthma with fungal sensitisation and allergic bronchopulmonary aspergillosis/allergic bronchopulmonary mycosis).
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3. Oral anticoagulant monotherapy versus oral anticoagulant plus antiplatelet therapy in adults with stable coronary artery disease.
3. 口服抗凝药单药治疗与口服抗凝药联合抗血小板治疗在稳定型冠状动脉疾病成人患者中的比较PMID:日期:2026-09-30This is a protocol for a Cochrane review (intervention). The objectives are as follows: To assess the benefits and harms of oral anticoagulant monotherapy compared with oral anticoagulant plus antiplatelet therapy in adults with stable coronary artery disease requiring long-term anticoagulation.
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4. Oral appliances for obstructive sleep apnoea in adults.
PMID:日期:2026-09-29This is a protocol for a Cochrane review (intervention). The objectives are as follows: To evaluate the benefits and harms of oral appliances for obstructive sleep apnoea in adults.
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5. Treat-to-target strategies for low-density lipoprotein cholesterol and triglyceride levels for primary and secondary prevention of cardiovascular disease in adults with dyslipidaemia.
5. 针对血脂异常成人患者心血管疾病一级和二级预防的低密度脂蛋白胆固醇和甘油三酯水平的达标治疗策略PMID:日期:2026-09-28This is a protocol for a Cochrane review (intervention). The objectives are as follows: To evaluate the benefits and harms of a treat-to-target (goal-directed) strategy versus a no-target strategy for lipid-lowering therapy in the primary and secondary prevention of cardiovascular disease in adults with dyslipidaemia.
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6. Blood pressure targets for hypertension in people with diabetes mellitus.
6. 糖尿病患者高血压的血压目标PMID:日期:2026-09-25This is a protocol for a Cochrane review (intervention). The objectives are as follows: To determine if lower blood pressure (BP) targets (i.e. ≤ 130/85 mmHg), compared with standard BP targets (i.e. ≤ 140 to 160/90 to 100 mmHg) are associated with reduction in mortality and morbidity in people with elevated BP and diabetes mellitus.
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7. Red blood cell transfusion to treat or prevent complications in sickle cell disease: an overview of Cochrane reviews.
7. 红细胞输注治疗或预防镰状细胞病并发症：Cochrane综述概述PMID:日期:2026-09-24Sickle cell disease (SCD) is one of the most common severe monogenic disorders globally. SCD can cause severe pain, significant end-organ damage, pulmonary complications, and premature death. Red blood cell (RBC) transfusions are used to treat complications of SCD, e.g. acute chest syndrome (ACS), or they can be part of a regular long-term transfusion programme to prevent SCD complications. To summarise the evidence from Cochrane reviews of the benefits and harms of RBC transfusions versus no transfusion, or restrictive transfusion (to increase the total haemoglobin) versus liberal transfusion (to decrease the haemoglobin S level below a specified percentage), for treating or preventing complications experienced by people with SCD. We searched the Cochrane Database of Systematic Reviews on 3 June 2026. We included Cochrane reviews of randomised or quasi-randomised controlled trials that addressed various SCD complications and had RBC transfusion as an intervention or comparator. We assessed the methodological quality of included reviews according to the AMSTAR (A MeaSurement Tool to Assess systematic Reviews) quality assessment. The primary outcomes of the overview were: mortality from any cause; SCD-related serious adverse events; and transfusion-related adverse events. We extracted GRADE assessments from included reviews. We included 17 reviews, 11 had no included studies with an RBC transfusion intervention. Six reviews included trials with participants randomised to RBC transfusion; in one of these reviews, with no usable data, only 10 participants were randomised. This overview focuses on the five remaining reviews. Five reviews (containing nine trials with 1502 participants) reported data comparing short- or long-term RBC transfusions versus standard care; disease-modifying agents; a restrictive versus a liberal transfusion strategy; and long-term RBC transfusions versus transfusions to treat complications. All reviews were high-quality according to AMSTAR, however, the certainty of the evidence was variable across outcomes, with most being very-low certainty. Trials were downgraded according to GRADE methodology for risk of bias, indirectness (most trials were conducted in children with the HbSS phenotype), and imprecision (outcomes had wide confidence intervals). In all five reviews and all comparisons there may be little or no difference in the risk of death (low or very low-certainty evidence). There were either no deaths or death was a rare event. In all five reviews and all comparisons, evidence for several outcomes was of very-low certainty. These were: transfusion reactions, development of alloantibodies and serious infections. Short-term RBC transfusion versus standard care (one review: two trials, 434 participants) All reported outcomes were very-low certainty evidence. Long-term RBC transfusion versus standard care (two reviews: three trials, 405 participants) In children and adolescents at high risk of stroke, long-term RBC transfusions probably decrease the risk of stroke (RR 0.12, 95% CI 0.03 to 0.49; 2 trials, 326 participants; moderate-certainty evidence) and may decrease the risk of ACS (RR 0.24, 95% CI 0.12 to 0.48; 2 trials, 326 participants, low-certainty evidence) and painful crisis (RR 0.62, 95% CI 0.46 to 0.84; 2 trials, 326 participants; low-certainty evidence) compared to standard care. Long-term RBC transfusions may also decrease the risk of silent cerebral infarcts (SCI) in children with abnormal transcranial doppler (TCD) velocities (RR 0.11, 95% CI 0.02 to 0.86; 1 trial, 124 participants; low-certainty evidence), but there may be little or no difference in the risk of SCI in children with normal TCD velocities and previous SCI (RR 0.70, 95% CI 0.23 to 2.13; 1 trial, 196 participants; low-certainty evidence). In children and adolescents already receiving long-term RBC transfusions for preventing stroke, compared to standard care, continuing long-term RBC transfusions may reduce the risk of SCI (RR 0.29, 95% CI 0.09 to 0.97; 1 trial 77 participants; low-certainty evidence). In children with normal TCD velocities and SCI, RBC transfusions may increase the risk of iron overload (incidence rate ratio 14.42, 95% CI 5.41 to 875.17; 1 trial, 121 participants; low-certainty evidence). Long-term RBC transfusion versus RBC transfusion to treat complications (one review: one trial, 72 participants) In pregnant women, long-term RBC transfusions may decrease the risk of painful crisis compared to transfusion for complications (RR 0.28, 95% CI 0.12 to 0.67; 1 trial, 72 participants, low-certainty evidence). RBC transfusion versus disease-modifying agents (hydroxyurea) (two reviews: two trials; 254 participants) For primary prevention of stroke in children with abnormal TCD and no severe vasculopathy on magnetic resonance imaging or magnetic resonance angiography, who have received at least one year of RBC transfusions, there may be little or no difference in the risk of iron overload between RBC transfusion and disease-modifying agents (mean difference (MD) -1.80, 95% CI -5.16 to 1.56; 1 trial, 121 participants; low-certainty evidence); all SCD-related outcomes were very-low certainty evidence. For secondary prevention of stroke in children and adolescents, hydroxyurea with phlebotomy may increase the risk of painful crisis (RR 3.15, 95% CI 1.23 to 8.11; 1 trial, 133 participants; low-certainty evidence) and global SCD serious adverse events compared to RBC transfusion (RR 3.10, 95% CI 1.42 to 6.75; 1 trial, 133 participants; low-certainty evidence). There may be little or no difference in the risk of iron overload (low-certainty evidence). Restrictive versus liberal RBC transfusion strategy (one review: one trial; 230 participants) All reported outcomes were very-low certainty evidence. This overview provides support from two high-quality Cochrane reviews for the use of RBC transfusions in preventing stroke in children and adolescents at high risk of stroke (abnormal TCDs or SCI) and evidence that it may decrease the risk of SCI in children with abnormal TCD velocities. In addition, RBC transfusions may reduce the risk of ACS and painful crisis in this population. This overview highlights the lack of high-quality evidence in adults with SCD and the number of reviews that have no evidence for the use of RBC transfusions across a spectrum of SCD complications. The variable and often incomplete reporting of patient-relevant outcomes in the included trials, such as SCD-related serious adverse events and quality of life, is also concerning. This review update had no funding. Protocol (2016) DOI: 10.1002/14651858.CD012082 Original review (2018) DOI: 10.1002/14651858.CD012082.pub2.
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8. Zuclopenthixol acetate for acute schizophrenia and similar major mental illnesses.
8. 醋酸珠氯噻醇用于急性精神分裂症及类似重性精神疾病PMID:日期:2026-09-24Schizophrenia is a serious mental health condition that can cause long-term disability and major disruption to daily life. People living with schizophrenia may experience psychosis, causing frightening and distressing experiences. At times, this distress may lead to aggressive or violent behaviour towards themselves or others. On such occasions, medications used for the management of aggression and agitation in psychiatric settings must have a rapid onset of action, low frequency of administration and exhibit a minimal adverse-effect profile. Zuclopenthixol acetate is reported to have these properties. To evaluate the clinical effectiveness of zuclopenthixol acetate in the management of acute behavioural disturbance in people with acute schizophrenia and similar major mental illnesses, compared with other pharmacological agents used for the treatment of similar clinical presentations. We searched the Cochrane Schizophrenia Study-Based Register of Randomised Controlled Trials, CENTRAL and MEDLINE, supplemented by citation searching and contacting study authors. The date of the last search was 8 September 2025. Randomised controlled trials (RCTs) involving participants with major mental illnesses that compared zuclopenthixol acetate with standard pharmacological treatments were included, with predefined exclusion criteria applied. Our outcomes were tranquillisation, sedation (measured between 15 minutes and 48 hours), global state (including the need for additional medications), behaviour, mental state and adverse effects (evaluated up to seven days). These outcomes were also used to compare lower doses of zuclopenthixol acetate (25 mg to 50 mg per injection) with higher doses (50 mg to 100 mg per injection). We used the Cochrane risk of bias tool (RoB 1). Data extraction and cross-checking were performed independently by the review authors, and the risk of bias in the included studies was systematically assessed. We synthesised results for each outcome using meta-analysis where possible. Review Manager and the GRADE profiler were used for data synthesis and evaluation of the certainty of evidence. We included 11 studies with 714 participants. All studies were RCTs and investigated the effect of intramuscular zuclopenthixol acetate. The risk of bias was variable: two studies reported adequate random sequence generation, one confirmed allocation concealment, four reported participant blinding and five reported assessor blinding. Outcomes were clearly reported in three studies, but selective reporting was identified in 10 of 11 included studies. Overall, the certainty of evidence ranged from moderate to very low. Tranquillisation and sedation There may be no difference in the proportion of participants achieving tranquillisation at 15 minutes between zuclopenthixol acetate versus intramuscular haloperidol plus promethazine (risk ratio (RR) 2.27, 95% confidence interval (CI) 0.89 to 5.81; P = 0.09; 1 study, 74 participants; low-certainty evidence). Zuclopenthixol acetate may not differ from standard medications in the number of participants who were sedated at two hours (RR 0.60, CI 0.27 to 1.34; P = 0.21; 1 study, 40 participants); four hours (RR 1.04, CI 0.76 to 1.43; P = 0.81, I = 85%; 2 studies, 114 participants); or eight hours (RR 0.72, CI 0.51 to 1.03; P = 0.07; 1 study, 40 participants). At 15 minutes, the evidence suggests that probably more participants in the haloperidol plus promethazine group were sedated than in the zuclopenthixol acetate group (RR 1.31, CI 1.06 to 1.63; P = 0.01; 1 study, 74 participants; moderate-certainty evidence). In contrast, probably more participants in the zuclopenthixol acetate group were sedated at 24 hours (RR 0.25, CI 0.11 to 0.54; P < 0.001; 1 study, 74 participants; moderate-certainty evidence; and at 48 hours (RR 0.62, CI 0.43 to 0.89; P = 0.009; 1 study, 74 participants). Global state No differences were identified between zuclopenthixol acetate and standard medications on the Clinical Global Impression scale, the Brief Psychiatric Rating Scale (BPRS) or the Nurses' Observational Scale for Inpatient Evaluation. No differences were identified between zuclopenthixol acetate and standard medications regarding the use of supplementary antipsychotics (RR 1.49, CI 0.97 to 2.30; P = 0.07, I = 79%; 3 studies, 134 participants), although the use of additional benzodiazepines was lower in the zuclopenthixol acetate group (RR 0.03, CI 0.00 to 0.47; P = 0.01; 1 study, 50 participants); however, the evidence for these outcomes was very uncertain. There was no evidence of a difference between groups in aggressive or related behaviours among participants (2 studies). Adverse effects The evidence suggests that there may be no difference in adverse effects between zuclopenthixol acetate and standard medications (day 1: RR 0.62, CI 0.29 to 1.31; P = 0.21, I = 0%; 2 studies, 222 participants; low-certainty evidence). Dose comparison Zuclopenthixol acetate doses of 25 mg to 50 mg per injection may be as effective as doses of 50 mg to 100 mg per injection for mental state outcomes (BPRS: RR 1.10, CI 0.69 to 1.76; P = 0.69; 1 study, 30 participants) and there may be no difference in adverse effects (Treatment Emergent Symptom Scale (TESS): RR 2.33, CI 0.74 to 7.35; P = 0.15; 1 study, 30 participants), but the evidence is very uncertain. Based on the evidence in this review, there may be no difference between zuclopenthixol acetate and standard medications in the management of acute psychiatric symptoms, tranquillisation and adverse events. Zuclopenthixol acetate was probably associated with a greater degree of sedation at 24 and 48 hours of administration. The use of zuclopenthixol acetate may be associated with a lower requirement for adjunctive benzodiazepines, but this is uncertain. Doses of zuclopenthixol acetate of 25 mg to 50 mg per injection may be as effective as doses of 50 mg to 100 mg per injection (very low-certainty evidence). Recommendations favouring zuclopenthixol acetate over standard medications for the management of acute behavioural disturbance should be interpreted with caution, given the methodological limitations of most included studies. This study received no external funding. Original review (2001) DOI: 10.1002/14651858.CD000525 Review update (2004) DOI: 10.1002/14651858.CD000525.pub2 Review update (2012) DOI: 10.1002/14651858.CD000525.pub3.
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9. Combined hormonal versus nonhormonal versus progestin-only contraceptives for postpartum contraception in lactating individuals.
PMID:日期:2026-09-23This is a protocol for a Cochrane review (intervention). The objectives are as follows: To evaluate the benefits and harms of combined hormonal, progestin-only, and nonhormonal contraceptive methods for postpartum contraception in lactating individuals.
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10. Electrophysiology procedures for preventing falls in older people living in the community.
10. 预防社区老年人跌倒的电生理检查程序PMID:日期:2026-09-23This is a protocol for a Cochrane review (intervention). The objectives are as follows: To assess the efficacy and safety of electrophysiology procedures in preventing falls among older people living in the community.