麻杏食肝汤联合阿奇霉素治疗儿童肺炎支原体肺炎的疗效和安全性：系统评价及Meta分析

IF 2.1 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of Clinical Pharmacy and Therapeutics Pub Date : 2023-02-04 DOI:10.1155/2023/2596562

Qiong Huang, Qiong Zhang, Si-Jian Li

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引用次数: 0

摘要

背景本研究的主要目的是全面评价麻杏食肝汤（MSD）和阿奇霉素治疗小儿肺炎支原体肺炎（MPP）的疗效。材料和方法。我们从开始到2021年4月，在Medicine、Embase、ClinicalTrials.gov、Cochrane Library、PubMed、CNKI、WangFang和VIP数据库中，全面回顾了默沙东联合阿奇霉素治疗儿童MPP的随机对照试验研究文献。对于二分法数据，采用了dds比率（OR），而对于作为效应大小的连续变量，采用了平均差（MD），这两者都在效应大小和95%置信区间（CI）中得到了证明。后果荟萃分析共纳入49项研究，涉及5704名患者。结果表明，MSD与阿奇霉素联合用药可显著提高临床疗效（OR = 5.31，95%可信区间：（4.35，6.49），p < 0.001），并减少了胸部X射线恢复时间（MD = −2.25，95%置信区间：（−2.86，−1.65），p < 0.001），咳嗽持续时间（MD = −2.53，95%CI：（−2.93.−2.12）和p < 0.001）、CRP（MD = −7.84，95%置信区间：（−9.51，−6.17），p < 0.001）、发烧持续时间（MD = −1.53，95%置信区间：（−1.78，−1.28），p < 0.001），住院天数（MD = −2.70，95%置信区间：（−3.35，−2.06），p < 0.001），湿啰音持续时间（MD = −2.00，95%置信区间：（−2.33，−1.68），p < 0.001）和不良反应（OR = 0.55，95%置信区间：（0.41，0.75），p < 0.001）。荟萃回归分析表明，在比较各组之间的结果时，病程和用药时间会导致研究的异质性。结论MSD和阿奇霉素联合治疗年轻患者的MPP效果更好。这些发现需要额外的高质量、大样本随机对照试验来证实。

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Efficacy and Safety of Integrated Maxing Shigan Decoction and Azithromycin for Mycoplasma Pneumoniae Pneumonia in Children: A Systematic Review and Meta-Analysis

Background. The primary objective of this study was to thoroughly assess the effectiveness of treating pediatric mycoplasma pneumoniae pneumonia (MPP) with Maxing Shigan decoction (MSD) and azithromycin. Materials and Methods. We comprehensively reviewed the literature for randomized controlled trials research on MPP treated by MSD combined with azithromycin in children in the databases of Medicine, Embase, ClinicalTrials.gov, Cochrane Library, PubMed, CNKI, WangFang, and VIP from inception to April 2021. dds ratio (OR) was used for dichotomous data, while the mean difference (MD) was adopted for continuous variables as effect size, both of which were demonstrated in effect size and 95% confidence intervals (CI). Results. A total of 49 studies with 5704 patients were included in the meta-analysis. The results showed that MSD combined with azithromycin significantly improved the clinical efficacy (OR = 5.31, 95% CI: (4.35, 6.49), and p < 0.001 ) and reduced the chest X-rays recovery time (MD = −2.25, 95% CI: (−2.86, −1.65), and p < 0.001 ), cough duration (MD = −2.53, 95% CI: (−2.93. −2.12), and p < 0.001 ), CRP (MD = −7.84, 95% CI: (−9.51, −6.17), and p < 0.001 ), fever duration (MD = −1.53, 95% CI: (−1.78, −1.28), and p < 0.001 ), hospital days (MD = −2.70, 95% CI: (−3.35, −2.06), and p < 0.001 ), moist rales duration (MD = −2.00, 95% CI: (−2.33, −1.68), and p < 0.001 ), and adverse effects (OR = 0.55, 95% CI: (0.41, 0.75), and p < 0.001 ) when compared with azithromycin alone in the treatment of MPP in children. Meta-regression analysis demonstrated that the course of disease and duration of medication contribute to the heterogeneity across studies when comparing outcomes between groups. Conclusion. MSD and azithromycin worked better when used in conjunction to treat MPP in young patients. These findings require confirmation by additional high-quality, big sample RCTs.

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来源期刊

Journal of Clinical Pharmacy and Therapeutics 医学-药学

CiteScore

4.10

自引率

5.00%

发文量

226

审稿时长

6 months

期刊介绍： The Journal of Clinical Pharmacy and Therapeutics provides a forum for clinicians, pharmacists and pharmacologists to explore and report on issues of common interest. Reports and commentaries on current issues in medical and pharmaceutical practice are encouraged. Papers on evidence-based clinical practice and multidisciplinary collaborative work are particularly welcome. Regular sections in the journal include: editorials, commentaries, reviews (including systematic overviews and meta-analyses), original research and reports, and book reviews. Its scope embraces all aspects of clinical drug development and therapeutics, including: Rational therapeutics Evidence-based practice Safety, cost-effectiveness and clinical efficacy of drugs Drug interactions Clinical impact of drug formulations Pharmacogenetics Personalised, stratified and translational medicine Clinical pharmacokinetics.