ISSN 1674-3865  CN 21-1569/R
主管：国家卫生健康委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
中国中西医结合儿科学

中国中西医结合儿科学 ›› 2021, Vol. 13 ›› Issue (2): 131-.

• 临床研究 • 上一篇    下一篇

麻杏石甘汤联合阿奇霉素治疗小儿肺炎支原体肺炎随机对照研究的疗效Meta分析

蒋慧，郑新，曾言敏，马玉萍，彭文禹   

  1. 611137 成都，成都中医药大学2017级中医学专业本科生（蒋慧，郑新，曾言敏，马玉萍）；成都中医药大学附属医院儿科（彭文禹）
  • 出版日期:2021-04-25 发布日期:2021-05-18
  • 通讯作者: 彭文禹，E-mail：644894097@qq.com
  • 作者简介:蒋慧（1999-），女，成都中医药大学2017级本科生在读。研究方向：儿童常见病的防治

Randomized controlled trial and Meta-analysis of the therapeutic effect of Maxing Shigan decoction combined with azithromycin on Mycoplasma pneumoniae pneumonia in children

JIANG Hui，ZHENG Xin，ZENG Yanmin，MA Yuping，PENG Wenyu.   

  1. Chengdu University of Traditional Chinese Medicine,Chengdu 611137,China
  • Online:2021-04-25 Published:2021-05-18

PDF (PC)

117

摘要： 目的:对麻杏石甘汤联合阿奇霉素治疗小儿肺炎支原体肺炎(MPP)的疗效与安全性进行系统评价。
方法:计算机检索PubMed、Cochrane Library、CNKI、VIP、WanFang、CBM数据库，纳入麻杏石甘汤联合阿奇霉素治疗小儿MPP的随机对照试验(RCT)，检索时间为从1998年1月至2020年3月；由2名研究者分别按纳入与排除标准独立进行文献筛选、提取资料与质量评价，使用Revman 5.3、Stata 15.0统计软件进行Meta分析。
结果:纳入22项RCT，共2 887名研究对象。Meta分析结果显示，与单纯使用阿奇霉素相比，麻杏石甘汤联合阿奇霉素能够提高临床疗效［OR=6.26，95%CI(4.75，8.26)，P<0.000 01］，减少不良反应［MD=0.25，95%CI(0.13，0.50)，P<0.000 01］；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，麻杏石甘汤联合阿奇霉素效果均优于对照组，差异均有统计学意义（P<0.05）。
结论:麻杏石甘汤联合阿奇霉素治疗小儿MPP可提高临床疗效，改善临床症状。但由于纳入研究数量有限、方法学质量不高，尚需要高质量、大样本的RCT加以证实。

关键词: 肺炎支原体肺炎, 麻杏石甘汤, 阿奇霉素, Meta分析, 儿童

Abstract: Objective:To systematically evaluate the efficacy and safety of Maxing Shigan decoction combined with azithromycin in the treatment of Mycoplasma pneumoniae pneumonia in children.
Methods:By searching the databases of PubMed, Cochrane Library, CNKI, VIP, Wanfang and CBM, the randomized controlled trials(RCT) on Maxing Shigan decoction combined with azithromycin in the treatment of Mycoplasma pneumoniae pneumonia(MPP) in children were included. The retrieval time was from January 1998 to March 2020. Two researchers independently screened the literature, extracted data and evaluated the quality according to the inclusion and exclusion criteria, and then Revman 5.3 and Stata 15.0 were used for Meta-analysis.
Results:Totally 22 RCTs were included, involving 2 887 subjects. The results of Meta-analysis showed that the combination of Maxing Shigan decoction with azithromycin could improve the clinical efficacy［OR=6.26,95%CI(4.75,8.26),P<0.000 01］and reduce the adverse reactions［MD=0.25,95%CI(0.13,0.50),P<0.000 01］, as compared with azithromycin alone. Regarding the improvement of the clinical symptoms and signs, including the time of fever relief, the time of cough disappearance, the time of lung rales disappearance, and the time of the disappearance of lung X-ray erosion shadow, the effect of Maxing Shigan decoction combined with azithromycin was better than that of azithromycin alone. The above differences were statistically significant(P<0.05).
Conclusion:Maxing Shigan decoction combined with azithromycin can improve the clinical efficacy on and the symptoms of Mycoplasma pneumoniae pneumonia in children. However, due to the limited quantity of trials included and the poor quality of the methodology, high-quality and large-sample randomized controlled trials are needed to confirm the results.

Key words: Mycoplasma pneumoniae pneumonia, Maxing Shigan decoction, Azithromycin, Meta-analysis, Children