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喜炎平注射液联合阿奇霉素治疗儿童支原体肺炎的疗效与安全性:Meta分析

[Efficacy and safety of Xiyanping injection combined with azithromycin in treating mycoplasma pneumonia of children: Meta-analysis].

作者信息

Luo Yu-Jun, Wen Xiao-Ying, Ni Xiao-Liang, Xiao Xiao-Lan

机构信息

Department of Pediatrics, Second Affiliated Hospital, Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Traditional Chinese Medicine), Guangzhou 510120, China.

出版信息

Zhongguo Zhong Yao Za Zhi. 2018 May;43(10):2153-2161. doi: 10.19540/j.cnki.cjcmm.2018.0068.

Abstract

To systemically evaluate the safety and efficacy of Xiyanping injection combined with azithromycin in the treatment of mycoplasmal pneumonia in children. PubMed, Wanfang Data, CNKI, VIP and CBM were used to search for the clinical randomized controlled trials on Xiyanping injection combined with azithromycin in the treatment of mycoplasmal pneumonia in children from database establishment to July, 2017. The papers were screened according to the established inclusion and exclusion criteria, and then the quality of the included studies was evaluated to extract valid data for Meta-analysis by using Revman 5.3 software. A total of 31 clinical randomized controlled trials were included, involving 2 881 patients. Meta-analysis showed that as compared with azithromycin alone, the combination of azithromycin with azithromycin had obvious advantages in the total effective rate(OR=5.42,95%CI[3.98,7.38],<0.000 01), fever clearance time(MD=-1.29,95%CI[-1.51,-1.08],<0.000 01), cough disappearance time (MD=-1.72,95%CI[-1.99,-1.46],<0.000 01), lung wet rales disappearance time(MD=-1.51,95%CI[-1.88,-1.14],<0.000 01), chest X-ray recovery time(MD=-2.72,95%CI[-3.82,-1.63],<0.000 01), shortening the hospital stay(MD=-1.88,95%CI[-2.26,-1.50],<0.000 01), reducing the incidence of adverse reactions(MD=0.51,95%CI[0.33,0.79],=0.002), and other aspects, with statistically significant difference. Based on the existing evidences, Xiyanping injection combined with azithromycin in the treatment of mycoplasmal pneumonia in children can significantly improve the overall clinical efficiency, shorten the hospital stay and reduce the incidence of adverse reactions. However, the clinical trials of existing small randomized controlled trials have low quality of methodology and require a large sample of high quality clinical trials for further validation.

摘要

系统评价喜炎平注射液联合阿奇霉素治疗小儿支原体肺炎的安全性和有效性。检索PubMed、万方数据、中国知网、维普资讯和中国生物医学文献数据库,收集从建库至2017年7月喜炎平注射液联合阿奇霉素治疗小儿支原体肺炎的临床随机对照试验。按照既定的纳入和排除标准筛选文献,然后对纳入研究的质量进行评价,采用Revman 5.3软件提取有效数据进行Meta分析。共纳入31项临床随机对照试验,涉及2 881例患者。Meta分析结果显示,与单用阿奇霉素相比,喜炎平注射液联合阿奇霉素在总有效率(OR=5.42,95%CI[3.98,7.38],P<0.000 01)、退热时间(MD=-1.29,95%CI[-1.51,-1.08],P<0.000 01)、咳嗽消失时间(MD=-1.72,95%CI[-1.99,-1.46],P<0.000 01)、肺部湿啰音消失时间(MD=-1.51,95%CI[-1.88,-1.14],P<0.000 01)、胸部X线恢复时间(MD=-2.72,95%CI[-3.82,-1.63],P<0.000 01)、缩短住院时间(MD=-1.88,95%CI[-2.26,-1.50],P<0.000 01)、降低不良反应发生率(MD=0.51,95%CI[0.33,0.79],P=0.002)等方面具有明显优势,差异有统计学意义。基于现有证据,喜炎平注射液联合阿奇霉素治疗小儿支原体肺炎可显著提高临床总有效率,缩短住院时间并降低不良反应发生率。然而,现有小样本随机对照试验的临床试验方法学质量较低,需要大样本高质量的临床试验进一步验证。

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