孟鲁司特辅助治疗咳嗽变异性哮喘的Meta分析

目的:评价孟鲁司特辅助治疗咳嗽变异性哮喘的疗效。方法:系统检索中国生物医学文献数据库(CBM)、中国期刊全文数据库(CNKI)、中文科技期刊全文数据库(VIP)和万方数据库,纳入孟鲁司特治疗咳嗽变异性哮喘的随机对照试验,对纳入文献进行质量评价并应用RevMan5.0软件对同质性结果进行Meta分析。结果:共纳入13篇报道,所有文献质量均为C级。共收入受试者994例,其中试验组518例,对照组476例。对照组采用常规单药治疗(支气管扩张剂、吸入型糖皮质激素、抗组胺药等);试验组在对照组的基础上加用孟鲁司特治疗,剂量、疗程不限。Meta分析结果显示:2组治疗结束时,有效率差异有统计学意义[RR=1.12,95%CI(1.04,1.20)];咳嗽缓解时间和消失时间差异也有统计学意义,MD及其95%CI分别为:-2.15(-3.08,-1.22)、-2.11(-3.61,-0.62);复发率差异无统计学意义[RR=0.59,95%CI(0.26,1.36)]。结论:根据当前国内证据,与常规单药支持治疗比较,在其基础上加用孟鲁司特治疗咳嗽变异性哮喘效果更好。

Meta-analysis of Adjunctive Therapy of Montelukast for Cough Variant Asthma in China

OBJECTIVE： To evaluate the therapeutic efficacy of adjunctive therapy of montelukast for cough variant asthma. METHODS： Retrieved from CBM, CNKI, VIP and Wanfang database, randomized controlled trials （RCTs） on cough variant asthma treated with montelukast were included. The quality of included literatures was evaluated and Meta-analysis was performed using RevMan 5.0 software. RESULTS： A total of 13 RCTs were included and the qualities of literatures were maintained at grade C. A total of 994 cases, 518 cases were included in trial group and 476 cases in control group. Both groups were given conventional therapy of single drug （bronchodilator, corticosteroid inhalation, antihistamine drugs）. Trial group were additionally given montelukast without limit of dosage and treatment course. Meta-analysis indicated： the total effective rate was statistically significant[RR= 1.12, 95% CI （1.04, 1.20）]; there were significant differences in cough relief time and disappearing time, MD and 95% CI were -2.15（- 3.08,- 1.22） and -2.11（-3.61,-0.62）; there was no significant difference in recurrence rate [RR=0.59, 95% CI （0.26, 1.36）]. CONCLUSION： Based on the current domestic evidence, conventional therapy of single drug combined with montelukast is better than conventional therapy in the treatment of cough variant asthma.