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