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系统评价与Meta分析

系统评价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有效性和安全性。计算机检索中国医学文献数据库(SinoMed)、维普数据库(VIP)、中国期刊全文数据库(CNKI)和万方数据库(WanFang)以及英文数据库PubMed,Cochrane Library,EMbase,收集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相关随机对照试验(RCT),检索时限均从建库至2019年9月。由2名研究者独立筛选文献、提取资料和评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析。共纳入17个RCT,包括1 712例患者。该研究按阿奇霉素的应用途径分为2个亚组:口服阿奇霉素亚组与静脉注射阿奇霉素亚组。结果显示:在改善临床症状体征,如缩短退热时间、咳嗽消失时间、肺部啰音消失时间、肺部X线浸润影消失时间方面,小儿消积止咳口服液联合口服阿奇霉素或静脉注射阿奇霉素均优于单用同剂型阿奇霉素;在提高临床总有效率方面,2个联合亚组均优于单用同剂型阿奇霉素组;在免疫指标IgM下降程度方面,联用小儿消积止咳口服液亦优于单用口服或静脉注射阿奇霉素,以上差异均有统计学意义。在不良反应发生率方面,联用小儿消积止咳口服液对比单用口服或静脉注射阿奇霉素未见明显差异,且均未见严重不良反应。该研究发现,小儿消积止咳口服液联合阿奇霉素治疗小儿支原体肺炎可提高临床疗效,且安全性较高。受纳入研究的数量和质量的限制,该研究结论尚需开展更多高质量研究予以证实。

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

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 1712 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.