喜炎平联合阿奇霉素治疗小儿肺炎的疗效与安全性系统评价和Meta分析
Xiyanping Plus Azithromycin Chemotherapy in Pediatric Patients with Pneumonia: A Systematic Review and Meta-Analysis of Efficacy and Safety.
作者信息
Li Qiao, Li Zhi-Yong, Zhang Jie, Guo Wen-Na, Xu Xiao-Meng, Sun Fa-Xin, Xu Hui
机构信息
School of Pharmacy, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, Key Laboratory of Molecular Pharmacology and Drug Evaluation (Yantai University), Ministry of Education, Yantai University, Yantai, China.
出版信息
Evid Based Complement Alternat Med. 2019 Aug 29;2019:2346583. doi: 10.1155/2019/2346583. eCollection 2019.
BACKGROUND
Xiyanping injection (XYP) is a well-known Chinese medicinal preparation reputed as a most effective alternative to antibiotics. XYP has been widely used in combination therapies to treat various infectious diseases, among which XYP plus azithromycin (AZM) chemotherapy is often used for the treatment of pneumonia in pediatric patients (p-MPP) in China.
OBJECTIVE
The present study just aimed to confirm whether XYP can improve the clinical efficacy and safety of AZM chemotherapy for p-MPP by performing meta-analysis and systematic review.
METHODS
A meta-analysis was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The randomized controlled trials (RCTs) concerning XYP plus AZM chemotherapy for p-MPP were selected, for which the main outcomes included overall response rate (ORR), antipyretic time, cough disappearance time, lung wet Rales disappearance time, hospitalization duration, and adverse drug reactions (ADRs). Based on the data extracted, the meta-analysis was conducted by using a standard data extraction form.
RESULTS
Nine RCTs involving 963 patients were included for meta-analysis. More concretely, the combination therapy showed the risk ratio (RR) and 95% confidence intervals (CI) of ORR and ADRs as (RR, 1.21 [95% CI, 1.15, 1.28]) and (RR, 0.37 [95% CI, 0.27, 0.51]), respectively. And other major outcomes were as follows: hospitalization durations (standard mean difference (SMD), -1.32 [95% CI, -1.48, -1.16]), antipyretic time (SMD, -1.26 [95% CI, -1.70, -0.83]), cough disappearance time (SMD, -1.07 [95% CI, -1.38, -0.75]), and the disappearance time of lung wet Rales (SMD, -0.83 [95% CI, -1.07, -0.60]). With statistically significant differences in various aspects, the combination therapy plus XYP displayed obvious advantages in contrast to AZM alone.
CONCLUSION
Overall, XYP might reduce the incidence of ADRs and significantly improve the clinical efficacy for p-MPP receiving AZM chemotherapy.
背景
喜炎平注射液（XYP）是一种著名的中药制剂，被誉为抗生素最有效的替代品。XYP已广泛用于联合治疗各种传染病，其中XYP联合阿奇霉素（AZM）化疗在中国常用于治疗小儿支原体肺炎（p-MPP）。
目的
本研究旨在通过进行荟萃分析和系统评价，证实XYP是否能提高AZM化疗治疗p-MPP的临床疗效和安全性。
方法
按照系统评价和荟萃分析的首选报告项目（PRISMA）指南进行荟萃分析。选择有关XYP联合AZM化疗治疗p-MPP的随机对照试验（RCT），其主要结局包括总缓解率（ORR）、退热时间、咳嗽消失时间、肺部湿啰音消失时间、住院时间和药物不良反应（ADR）。基于提取的数据，使用标准数据提取表进行荟萃分析。
结果
纳入9项RCT共963例患者进行荟萃分析。具体而言，联合治疗显示ORR和ADR的风险比（RR）及95%置信区间（CI）分别为（RR，1.21 [95% CI，1.15，1.28]）和（RR，0.37 [95% CI，0.27，0.51]）。其他主要结局如下：住院时间（标准均差（SMD），-1.32 [95% CI，-1.48，-1.16]）、退热时间（SMD，-1.26 [95% CI，-1.70，-0.83]）、咳嗽消失时间（SMD，-1.07 [95% CI，-1.38，-0.75]）和肺部湿啰音消失时间（SMD，-0.83 [95% CI，-1.07，-0.60]）。联合治疗在各方面差异均有统计学意义，与单独使用AZM相比显示出明显优势。
结论
总体而言，XYP可能降低ADR的发生率，并显著提高接受AZM化疗的p-MPP的临床疗效。
Zotero 插件