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阿奇霉素治疗支气管哮喘的有效性和安全性:一项荟萃分析

[Effectiveness and safety of azithromycin in the treatment of bronchial asthma: a meta-analysis].

作者信息

Liu Lu, Wang Gui-Zuo, Han Dong, Li Man-Xiang

机构信息

Respiratory Diseases Research Center, Second Affiliated Hospital, Xi'an Jiaotong University College of Medicine, Xi'an 710004, China.E-mail:

出版信息

Nan Fang Yi Ke Da Xue Xue Bao. 2015 Jan;35(1):83-7.

Abstract

OBJECTIVE

To evaluate the effectiveness and safety of azithromycin in treatment of bronchial asthma.

METHODS

Reports of randomized controlled trials (RCTs) describing azithromycin for treatment of asthma published before December 2013 were searched in CNKI, WANFANG, PubMed and Medline databases. The data of the included RCTs were extracted and the data quality was evaluated by two assessors independently. Meta-analyses were performed with Revman 5.1 software.

RESULTS

Eight RCTs were identified. Meta-analysis of the data showed that compared with the control group, azithromycin treatment significantly improved the patients' PEF (WMD=0.15, 95%CI=0.06-0.24, P=0.001), scores of asthma control test (ACT) (WMD=1.59, 95%CI=0.95-2.23, P<0.00001), and FEV1% (WMD=1.44, 95%CI=0.40-2.49, P=0.007), but the improvement of FEV1% was observed only in Chinese patients (WMD=1.48, 95%CI=0.40-2.57, P=0.007). The scores of asthma control questionnaire (WMD=0.07, 95%CI=-0.11-0.25, P=0.45) or asthma quality of life questionnaire (WMD=-0.06, 95%CI=-0.42-0.31, P=0.77) were not affected by azithromycin. No severe adverse events were reported in these included studies.

CONCLUSION

Azithromycin for asthma treatment can improve PEF, ACT and FEV1% (in Chinese patients only) but shows no significant effect on the quality of life of the patients. Azithromycin is well tolerated and may therefore be beneficial as adjuvant therapy for asthma.

摘要

目的

评估阿奇霉素治疗支气管哮喘的有效性和安全性。

方法

在CNKI、万方、PubMed和Medline数据库中检索2013年12月之前发表的描述阿奇霉素治疗哮喘的随机对照试验(RCT)报告。提取纳入RCT的数据,并由两名评估者独立评估数据质量。使用Revman 5.1软件进行荟萃分析。

结果

共纳入8项RCT。数据荟萃分析显示,与对照组相比,阿奇霉素治疗显著改善了患者的呼气峰流速(WMD = 0.15,95%CI = 0.06 - 0.24,P = 0.001)、哮喘控制测试(ACT)评分(WMD = 1.59,95%CI = 0.95 - 2.23,P < 0.00001)和第1秒用力呼气容积百分比(FEV1%)(WMD = 1.44,95%CI = 0.40 - 2.49,P = 0.007),但仅在中国患者中观察到FEV1%的改善(WMD = 1.48,95%CI = 0.40 - 2.57,P = 0.007)。哮喘控制问卷评分(WMD = 0.07,95%CI = -0.11 - 0.25,P = 0.45)或哮喘生活质量问卷评分(WMD = -0.06,95%CI = -0.42 - 0.31,P = 0.77)不受阿奇霉素影响。这些纳入研究中未报告严重不良事件。

结论

阿奇霉素治疗哮喘可改善呼气峰流速、ACT评分和FEV1%(仅在中国患者中),但对患者生活质量无显著影响。阿奇霉素耐受性良好,因此可能作为哮喘辅助治疗有益。

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