Department of Clinical Chinese Pharmacy, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China.
J Clin Pharm Ther. 2019 Oct;44(5):675-684. doi: 10.1111/jcpt.12855. Epub 2019 May 22.
An increasing macrolide resistance leads to complex clinical treatment schemes in mycoplasma pneumonia in children. Chinese herbal injection (CHI) is widely used to treat it and may provide a new treatment regimen. This study was conducted to systematically evaluate the efficacy of CHIs combined with azithromycin for treating mycoplasma pneumonia in children by Bayesian network meta-analysis.
Randomized controlled trials (RCTs) of CHIs combined with azithromycin for mycoplasma pneumonia in children were searched in electronic databases and related references from initiation to 30 October 2018. Two researchers conducted data extraction and risk of bias assessment. WinBUGS software and STATA software were adopted to analyse the data.
A total of 167 RCTs were included with 5 CHIs involving 16 144 patients. All CHIs combined with azithromycin had superior effects than azithromycin only among overall outcomes. Yanhuning injection combined with azithromycin ranked highest in four different outcomes and second in two based on surface under the cumulative ranking probabilities (SUCRA). Meanwhile, the results of MD and 95% CIs of concerned outcomes indicated that only Yanhuning injection combined with azithromycin had better response than other CHIs combined with azithromycin. Moreover, cluster analysis results revealed Reduning injection combined with azithromycin was associated with a positive effect on the three group outcomes. Similarly, it was found to be the top three ranking in all outcomes based on SUCRA.
Yanhuning injection combined with azithromycin and Reduning injection combined with azithromycin were found to be preferable treatments based on the data of this study.
支原体肺炎患儿大环内酯类耐药率不断升高，临床治疗方案日趋复杂。中药注射剂（CHI）广泛用于治疗支原体肺炎，可能提供新的治疗方案。本研究采用贝叶斯网状meta 分析系统评价 CHI 联合阿奇霉素治疗儿童支原体肺炎的疗效。
检索电子数据库及相关参考文献，收集截止至 2018 年 10 月 30 日 CHI 联合阿奇霉素治疗儿童支原体肺炎的随机对照试验（RCT）。由 2 名研究者进行数据提取和偏倚风险评估。采用 WinBUGS 软件和 STATA 软件进行数据分析。
共纳入 167 项 RCT，涉及 5 种 CHI，共纳入 16 144 例患儿。在总有效率方面，CHI 联合阿奇霉素均优于阿奇霉素单药治疗。基于排序概率曲线下面积（SUCRA），炎琥宁注射剂联合阿奇霉素在 4 项不同结局中排名最高，在 2 项结局中排名第二。同时，MD 及其 95%CI 结果显示，只有炎琥宁注射剂联合阿奇霉素的疗效优于其他 CHI 联合阿奇霉素。聚类分析结果显示，热毒宁注射剂联合阿奇霉素对三组结局有积极影响。同样，它在所有结局中基于 SUCRA 排名也在前三位。
本研究数据显示，炎琥宁注射剂联合阿奇霉素和热毒宁注射剂联合阿奇霉素可能是较好的治疗方案。
