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基于Ｍｅｔａ分析的山莨菪碱联合大环内酯类抗菌药治疗支原体肺炎临床评价研究

Meta analysis of Anisodamine Combined with Macrolide Antibiotics in the Treatment of Mycoplasma Pneumonia

DOI：

中文关键词: 山莨菪碱支原体肺炎Ｍｅｔａ分析随机对照试验

英文关键词:Anisodamine Mycoplasma pneumonia Meta analysis Randomized controlled trials

基金项目:国家自然科学基金项目（编号：８１４７３５４７、８１６７３８２９）；北京中医药大学与成都第一制药有限公司联合课题

作者	单位
刘雅清１〓段笑娇１〓成云芳２〓吴嘉瑞１〓曹博淦３〓李丽嫱４	１．北京中医药大学中药学院北京１０２４８８；２．成都第一制药有限公司；３．西安医学院第一附属医院呼吸科；４．首都医科大学附属北京天坛医院儿科

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中文摘要:

摘〓要〓目的：〖HTK〗综合评价山莨菪碱联合大环内酯类抗菌药治疗支原体肺炎的临床有效性与安全性。〖HTH〗方法：〖HTK〗计算机检索ＣＮＫＩ、ＷａｎＦａｎｇＤａｔａ、ＳｉｎｏＭｅｄ、ＶＩＰ、ＰｕｂＭｅｄ、Ｅｍｂａｓｅ、ＣｏｃｈｒａｎｅＬｉｂｒａｒｙ数据库，收集山莨菪碱联合大环内酯类抗菌药治疗支原体肺炎的随机对照试验，检索时限均为建库至２０１８年５月２３日。采用Ｃｏｃｈｒａｎｅ风险评价表对纳入研究的偏倚风险进行评价，并应用ＲｅｖＭａｎ５．３软件进行Ｍｅｔａ分析。〖HTH〗结果：〖HTK〗共纳入１３项研究，累计受试者１６６８例。Ｍｅｔａ分析结果显示，在西医常规联合大环内酯类抗菌药的基础上，加用山莨菪碱治疗支原体肺炎可以有效地提高临床总有效率［ＲＲ＝１．１１，９５％ＣＩ（１．０４，１．１９），Ｐ＝０．００２］，并可以缩短临床症状的消失时间［咳嗽：ＭＤ＝-１．５８，９５％ＣＩ（-１．８０，-１．３５），Ｐ＜０．００００１；气喘：ＭＤ＝-１．５９，９５％ＣＩ（-１．７７，-１．４１），Ｐ＜０．００００１；肺部啰音：ＭＤ＝-１．５８，９５％ＣＩ（-１．８３，-１．３３），Ｐ＜０．００００１］以及住院时间［ＭＤ＝-１．８１，９５％ＣＩ（-２．０２，-１．６０），Ｐ＜０．００００１］，提高患儿的免疫功能水平［ＩｇＡ：ＭＤ＝０．２２，９５％ＣＩ（０．１６，０．２９），Ｐ＜０．００００１；ＩｇＧ：ＭＤ＝１．４６，９５％ＣＩ（１．０８，１．８５），Ｐ＜０．００００１；ＩｇＭ：ＭＤ＝０．３４，９５％ＣＩ（０．１６，０．５２），Ｐ＝０．０００２］。〖HTH〗结论：〖HTK〗在西医常规联合大环内酯类抗菌药的基础上使用山莨菪碱治疗支原体肺炎与仅使用西医常规联合大环内酯类抗菌药相比有更好的疗效，但其安全性仍需进一步讨论。

英文摘要:

ABSTRACT〓Objective:〖WTBZ〗 To systematically evaluate the clinical efficacy and safety of anisodamine combined with macrolide antibiotics in the treatment of mycoplasma pneumonia. 〖WTHZ〗Methods:〖WTBZ〗Randomized controlled trials (RCTs) regarding anisodamine combined with macrolide antibiotics in the treatment of mycoplasma pneumonia were searched in CNKI, WanFang Ｄａｔａ, SinoMed, VIP, PubMed, Embase, Cochrane Library, which from the inception to May 23th, 2018. Quality of included RCTs was evaluated by the Cochrane Risk of Bias Assessment Tool, and then the required information was extracted and Meta analyzed by RevMan 5.3 software. 〖WTHZ〗Results:〖WTBZ〗 A total of 13 RCTs with 1 668 participants were included. In the Meta analysis, on the basis of conventional medicine combined with macrolide antibiotics, the use of anisodamine on the treatment of mycoplasma pneumonia can effectively improve the total effective rate [RR=1.11, 95%CI(1.04,1.19), P=0.002], shorten the time of clinical symptom disappearance [cough: MD=-1.58, 95%CI (-1.80, -1.35), P＜0.000 01; asthma: MD=-1.59, 95%CI(-1.77,-1.41), P＜0.000 01; lung rale: MD=-1.58, 95%CI (-1.83, -1.33), P＜0.000 01] and hospitalization [MD=-1.81, 95%CI (-2.02, -1.60), P＜0.000 01], and improve the immune function of patients [IgA: MD=0.22, 95%CI (0.16, 0.29), P＜0.000 01; IgG: MD=1.46, 95%CI (1.08, 1.85), P＜0.000 01; IgM: MD=0.34，95%CI(0.16, 0.52), P=0.000 2]. 〖WTHZ〗Conclusion:〖WTBZ〗Compared with only conventional medicine combined with macrolide antibiotics, using anisodamine to treat mycoplasma pneumonia on the basis of conventional medicine combined with macrolide antibiotics was more effective, but its safety needed to be further discussed.

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