Department of Respiratory, Yuxi Children's Hospital, Yuxi, Yunnan, China.
Geriatrics Department, Ningxia Wuzhong People's Hospital, Wuzhong, Ningxia, China.
Pediatr Pulmonol. 2024 Jun;59(6):1541-1551. doi: 10.1002/ppul.26960. Epub 2024 Mar 19.
This meta-analysis aims to assess the clinical effectiveness of combination therapy with montelukast sodium for the treatment of cough variant asthma (CVA) in children, intending to provide clinical evidence and data to guide the selection of clinical therapy. A literature review was conducted using numerous databases, including China National Knowledge Infrastructure (CNKI), Wanfang database, Embase, PubMed, and Web of Science, from inception to December 2023. Trials meeting the criteria for the combined treatment of montelukast sodium for CVA in children were included. Stata 16.0 software was utilized for meta-analysis. The combined treatment group received montelukast sodium in addition to the control group, while the control group received budesonide, fluticasone propionate, salmeterol-fluticasone, or ketotifen alone. This investigation included 18 papers. All subjects were from the Chinese population. Compared to the control group, the combined treatment group demonstrated a higher effective rate (relative ratio [RR] = 1.23, 95% confidence interval [CI]: 1.18-1.29, p < .001), but no difference in the incidence of adverse reactions (RR = 0.65, 95% CI: 0.42-1.02, p = .060) after treatment. Moreover, the peak expiratory flow (PEF) (SMD = 1.69, 95% CI: 1.09-2.30, p < .001), forced vital capacity (FVC) (SMD = 1.67, 95% CI: 0.94-2.39, p < .001), forced expiratory volume in 1 s (FEV1) (SMD = 1.74, 95% CI: 1.09-2.40, p < .001), and FEV1/FVC (SMD = 1.84, 95% CI: 0.41-3.28, p = .012) were significantly higher in the combined treatment group than in the control group after treatment. Compared with the control group, the levels of tumor necrosis factor-α (SMD = -2.38, 95% CI: -3.22 to -1.55, p < .001), IL-4 (SMD = -2.65, 95% CI: -3.26 to -2.04, p < .001), and IgE (SMD = -2.98, 95% CI: -3.24 to -2.72, p < .001) were significantly lower in the combined treatment group after treatment. The combined use of montelukast sodium in the treatment of pediatric CVA in China is associated with a significant clinical effect, making it a reasonable therapeutic approach.
本荟萃分析旨在评估孟鲁司特钠联合治疗儿童咳嗽变异性哮喘（CVA）的临床疗效，旨在为临床治疗选择提供临床证据和数据。使用多个数据库（包括中国知网、万方数据库、Embase、PubMed 和 Web of Science）对从开始到 2023 年 12 月的文献进行了综述。纳入符合儿童 CVA 联合孟鲁司特钠治疗标准的试验。使用 Stata 16.0 软件进行荟萃分析。联合治疗组在对照组的基础上加用孟鲁司特钠，对照组单独使用布地奈德、丙酸氟替卡松、沙美特罗氟替卡松或酮替芬。本研究纳入 18 篇论文。所有研究对象均来自中国人群。与对照组相比，联合治疗组的有效率更高（相对比值 [RR] = 1.23，95%置信区间 [CI]：1.18-1.29，p <.001），但治疗后不良反应发生率无差异（RR = 0.65，95% CI：0.42-1.02，p =.060）。此外，治疗后，联合治疗组的呼气峰流速（PEF）（SMD = 1.69，95% CI：1.09-2.30，p <.001）、用力肺活量（FVC）（SMD = 1.67，95% CI：0.94-2.39，p <.001）、第 1 秒用力呼气容积（FEV1）（SMD = 1.74，95% CI：1.09-2.40，p <.001）和 FEV1/FVC（SMD = 1.84，95% CI：0.41-3.28，p =.012）均明显高于对照组。与对照组相比，联合治疗组治疗后肿瘤坏死因子-α（SMD = -2.38，95% CI：-3.22 至 -1.55，p <.001）、IL-4（SMD = -2.65，95% CI：-3.26 至 -2.04，p <.001）和 IgE（SMD = -2.98，95% CI：-3.24 至 -2.72，p <.001）水平明显降低。在中国，孟鲁司特钠联合治疗儿童 CVA 具有显著的临床效果，是一种合理的治疗方法。
