匹多莫德对儿童反复呼吸道感染的疗效及免疫功能影响的Meta-分析

目的 系统评价匹多莫德对儿童反复呼吸道感染患者免疫功能的影响，为临床提供循证医学证据。方法 计算机检索PubMed、Embase、中国生物医学文献数据库（CBM）、中国知网（CNKI）、维普数据库（VIP）和万方数据库，收集匹多莫德联合常规治疗（试验组）对比单用常规治疗（对照组）对儿童反复呼吸道感染患者免疫功能水平影响的随机对照研究（RCT），检索时间为2000年1月-2018年3月，提取资料并评价质量后，采用RevMan 5.2软件进行Meta-分析。结果 共纳入14篇RCTs，1 287例患儿。Meta-分析结果显示试验组总有效率高于对照组（RR=1.30，95%CI=1.23~1.37，P<0.001），感染复发次数小于对照组（MD=-2.41，95%CI=-2.81~-2.01，P<0.001），退热时间、咳嗽缓解时间和肺部啰音消失时间均小于对照组（P<0.001）；IgA增加值（MD=0.40，95%CI=0.32~0.47，P<0.001）、IgM增加值（MD=0.36，95%CI=0.25~0.48，P<0.001）和IgG增加值（MD=1.39，95%CI=0.85~1.92，P<0.001）均显著大于对照组；CD3⁺增加值（MD=8.91，95%CI=5.16~12.67，P<0.001）、CD4⁺增加值（MD=5.52，95%CI=2.92~8.11，P<0.001）、CD8⁺增加值（MD=4.52，95%CI=2.21~6.84，P<0.001）和CD4⁺/CD8⁺增加值（MD=0.27，95%CI=0.16~0.39，P<0.001）均显著大于对照组。结论 匹多莫德能够显著改善儿童RRTI的免疫水平，从而提高总有效率和减少感染复发次数。

Meta-analysis of effective and immune function of pidomomod in children with recurrent respiratory tract infection

Objective To evaluate the immune function of pidotimod in children with recurrent respiratory tract infection (RRTI),and provide evidence-based medical evidence for the clinic.Methods The randomized controlled trials of pidotimod combined with conventional treatment (test group) vs conventional treatment (control group) of immune function in children with RRTI were searched from the database including Pubmed,Embase,CNKI,VIP,CBM and Wangfang Data by computer from January 2000 to March 2018.References of included studies were also retrieved.Screened studies according to inclusion and exclusion criteria,extracted valid data,and assessed the methodological quality of including literatures.Meta-analysis was performed using RevMan 5.2 software.Results A Total of 14 RCTs and 1 287 patients were included.Meta-analysis showed that compared with control group,test group improved total effective rate (RR=1.30,95%CI=1.23~1.37,P<0.001),reduced infection recurrence frequency (MD=-2.41,95%CI=-2.81~-2.01,P<0.001),and reduced the time of antipyretic,cough relief and lung snoring disappear,the difference were statistically (P<0.001);meanwhile improved the IgA level (MD=0.40,95%CI=0.32~0.47,P<0.001),improved the IgM level (MD=0.36,95%CI=0.25~0.48,P<0.001) and improved IgG level (MD=1.39,95%CI=0.85~1.92,P<0.001);improved the CD3⁺ level (MD=8.91,95%CI=5.16~12.67,P<0.001),improved the CD4⁺ level (MD=5.52,95%CI=2.92~8.11,P<0.001) and reduced CD8⁺ level (MD=-4.52,95%CI=-6.84~-2.21,P<0.001) and improved CD4⁺/CD8⁺ level (MD=0.27,95%CI=0.16~0.39,P<0.001).Conclusion Pidotimod can significantly improve the immune level of children with RRTI,thereby increasing the total effective rate and reducing the number of infection recurrences.