Qiu Jian-Li, Huang Li, Shao Ming-Yi, Chai Yu-Na, Zhang Hui-Juan, Li Xiang-Feng, Sun Xiao-Xu, Zhao Qian-Yi, Duan Fei, Zhai Wen-Sheng
Department of Pediatrics, First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou City, Henan Province.
Department of Rehabilitation Medicine, Foresea Life Insurance Guangzhou General Hospital, Guangzhou City, Guangdong Province.
Medicine (Baltimore). 2020 May 29;99(22):e20121. doi: 10.1097/MD.0000000000020121.
The aim of this study was to evaluate the efficacy and safety of azithromycin (AZI) combined with glucocorticoid (GC) in the treatment of children with refractory Mycoplasma pneumoniae.
Computer search for PubMed, EMbase, Cochrane Library, China Biomedical Literature Database (CBMdisc), China Knowledge Network (CNKI), Wanfang, VIP (VIP), and a randomized controlled trial (RCT) of AZI combined with GC in the treatment of children with refractory Mycoplasma pneumoniae pneumonia test (RCT), the search time limit is built until March 20, 2019. Two researchers independently performed literature screening, data extraction, and literature risk bias, and meta-analysis was performed using RevMan 5.3 software.
A total of 12 RCTs were included, including 1130 patients. Meta-analysis showed that AZI combined with GC therapy significantly improved the total effective rate of the disease compared with the conventional treatment group (odds ratio [OR] = 6.37; 95% confidence interval [CI] 4.03, 10.07; P < .00001; I = 0%), effectively shortened the antipyretic time (SMD = -2.29; 95% CI -2.70, -1.88; P < .0001); promoted lung inflammation absorption (SMD = -1.89; 95% CI -2.38, -1.40; P < .0001), reduced cough time (SMD = -2.39; 95% CI -2.80, -1.99; P < .0001); shortened hospital stay (SMD = -2.19; 95% CI -3.21, -1.17; P < .0001); improved imaging findings (OR = 5.38; 95% CI 1.09, 26.51, P = .04); reduced inflammation index (SMD = -3.15; 95% CI -4.93, -1.36; P = .004); improved immune function (SMD = 1.29; 95% CI -0.02, 2.60; P < .0001); had no significant adverse reactions (OR = 1.18; 95% CI 0.71, 1.98; P = .53).
According to the current limited research evidence, the addition of GCs to the conventional treatment of refractory Mycoplasma pneumoniae in children can improve the clinical efficacy to a certain extent, and the safety is better. However, due to the quality and quantity of the included literature, the conclusions of this study need to be confirmed by more high-quality studies.
本研究旨在评估阿奇霉素（AZI）联合糖皮质激素（GC）治疗难治性肺炎支原体感染患儿的疗效和安全性。
通过计算机检索PubMed、EMbase、Cochrane图书馆、中国生物医学文献数据库（CBMdisc）、中国知网（CNKI）、万方、维普（VIP），检索阿奇霉素联合糖皮质激素治疗难治性肺炎支原体肺炎的随机对照试验（RCT），检索时限为建库至2019年3月20日。两名研究人员独立进行文献筛选、数据提取和文献风险偏倚评估，并使用RevMan 5.3软件进行荟萃分析。
共纳入12项RCT，包括1130例患者。荟萃分析显示，与传统治疗组相比，阿奇霉素联合糖皮质激素治疗显著提高了疾病的总有效率（比值比[OR]=6.37；95%置信区间[CI] 4.03，10.07；P<.00001；I=0%），有效缩短了退热时间（标准化均数差[SMD]=-2.29；95% CI -2.70，-1.88；P<.0001）；促进肺部炎症吸收（SMD=-1.89；95% CI -2.38，-1.40；P<.0001），缩短咳嗽时间（SMD=-2.39；95% CI -2.80，-1.99；P<.0001）；缩短住院时间（SMD=-2.19；95% CI -3.21，-1.17；P<.0001）；改善影像学表现（OR=5.38；95% CI 1.09，26.51，P=.04）；降低炎症指标（SMD=-3.15；95% CI -4.93，-1.
