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[小儿消积止咳口服液联合阿奇霉素治疗小儿支原体肺炎的Meta分析]

[Meta-analysis of Xiaoer Xiaoji Zhike Oral Liqud combined with azithromycin in treatment of mycoplasma pneumonia in children].

作者信息

Li Tian-Li, Pu Feng-Lan, Wu Yang, Zhao Guo-Zhen, Li Hong-Zheng, Ma Qiu-Xiao, Li Bo

机构信息

Dongzhimen Hospital, Beijing University of Chinese Medicine Beijing 100700, China.

Beijing University of Chinese Medicine Beijing 100029, China.

出版信息

Zhongguo Zhong Yao Za Zhi. 2020 May;45(9):2193-2202. doi: 10.19540/j.cnki.cjcmm.20200211.503.

Abstract

Systematic evaluation of the effectiveness and safety of Xiaoer Xiaoji Zhike Oral Liqud combined with azithromycin in the treatment of mycoplasma pneumonia in children. Clinical literatures were retrieved from PubMed, Cochrane Library, EMbase, VIP, CNKI, SinoMed, WanFang from inception to September 2019. Two reviewers independently screened out the literatures, extracted data and assessed the risk of bias of the included studies. Then, Meta-analysis was performed by RevMan 5.3 software. A total of 17 RCT were included, involving 1 712 patients. In this study, there were two subgroups by the application approach of azithromycin: oral azithromycin subgroup and intravenous azithromycin subgroup. According to Meta-analysis results, in terms of the alleviation of clinical symptoms and signs, such as shortening of antifebrile time, cough disappeared time, rales disappearance time, and lung X-ray infiltrating shadow disappearance time, Xiaoer Xiaoji Zhike Oral Liquid combined with oral azithromycin or intravenous azithromycin were better than single-dose azithromycin; in the aspect of the improvement of the overall effective rate, the two combination subgroups were better than the single-use azithromycin; In terms of the decline of IgM, the combination subgroups were also more efficient than the single-use azithromycin, with statistically significant differences. In terms of the incidence of adverse reactions, there was no significant difference between the two combination subgroups and the single-use azithromycin in children, and no serious adverse reactions were found. In inclusion, Xiaoer Xiaoji Zhike Oral Liquid combined with azithromycin can improve the clinical efficacy in treating pediatric mycoplasma pneumonia, with a high safety. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.

摘要

小儿消积止咳口服液联合阿奇霉素治疗小儿支原体肺炎有效性和安全性的系统评价。从创刊至2019年9月检索PubMed、Cochrane图书馆、EMbase、维普、中国知网、中国生物医学文献数据库、万方数据库中的临床文献。两名评价员独立筛选文献、提取数据并评估纳入研究的偏倚风险。然后,采用RevMan 5.3软件进行Meta分析。共纳入17项随机对照试验,涉及1712例患者。本研究根据阿奇霉素的应用途径分为两个亚组:阿奇霉素口服亚组和阿奇霉素静脉滴注亚组。根据Meta分析结果,在缓解临床症状和体征方面,如缩短退热时间、咳嗽消失时间、啰音消失时间和肺部X线浸润影消失时间,小儿消积止咳口服液联合口服阿奇霉素或静脉滴注阿奇霉素均优于单剂量阿奇霉素;在提高总有效率方面,两个联合亚组均优于单用阿奇霉素;在IgM下降方面,联合亚组也比单用阿奇霉素更有效,差异有统计学意义。在不良反应发生率方面,两个联合亚组与单用阿奇霉素在儿童中无显著差异,未发现严重不良反应。综上所述,小儿消积止咳口服液联合阿奇霉素可提高小儿支原体肺炎的临床疗效,安全性高。由于纳入研究的数量和质量有限,需要更多高质量研究来验证上述结论。

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