| 摘要: |
| [摘要]目的：系统评价阿奇霉素辅助治疗支气管哮喘的疗效和安全性。方法：检索PubMed、Medline、EMBASE、Cochrane library、中国知网、中国生物医学文献数据库、万方数据库及维普中文科技期刊数据库，检索时间均从建库至2017年9月30日，筛选纳入10篇随机对照试验。根据Cochrane系统评价员手册对文献质量评价。所有研究对象分为阿奇霉素组和对照组（未使用阿奇霉素）。结局指标为哮喘急性发作频率、缓解药物的使用次数、哮喘生存质量问卷（AQLQ）评分、哮喘控制问卷（ACQ）评分、肺功能指标及不良反应发生率。应用RevMan软件进行Meta分析。结果：对纳入的10篇临床随机对照试验（n=1 060）进行Meta分析，结果显示：（1）阿奇霉素组与对照组哮喘急性发作频率比较差异无统计学意义（P>0.05）；对其进行亚组分析，两组非嗜酸粒细胞性患者哮喘急性发作频率比较差异有统计学意义（P=0.01），两组嗜酸粒细胞性患者哮喘急性发作频率比较差异无统计学意义（P=0.95）。（2）阿奇霉素组与对照组哮喘缓解药物使用次数比较差异无统计学意义（P>0.05）。（3）阿奇霉素组与对照组AQLQ（P>0.05）、ACQ（P>0.05）比较差异无统计学意义。（4）阿奇霉素组与对照组PEF（P<0.01）、FEV1（P<0.01）比较差异均有统计学意义。（5）阿奇霉素组恶心（P<0.01）、腹泻（P<0.01）与对照组比较差异均有统计学意义。结论：阿奇霉素可能预防部分持续性哮喘患者急性发作，可改善哮喘患者PEF、FEV1%水平，然而在减少哮喘药物的使用及改善生活质量无明显作用。长期服用阿奇霉素可能会增加恶心、腹泻等消化道不良反应，无其他严重不良反应。 |
| 关键词: 阿奇霉素 支气管哮喘 急性发作 Meta分析 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2019.04.003 |
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| 基金项目: |
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| Meta-Analysis of Efficacy and Safety of Azithromycin in the Adjuvant Treatment of Bronchial Asthma in Children |
| Zhang Maorong, Gong Caihui, Tu Jinwei, Wang Donghai, Dai Jihong |
| (Children’s Hospital of Chongqing Medical University, Key Laboratory of Developmental Diseases in Childhood of Ministry of Education, Chongqing 400014, China) |
| Abstract: |
| [Abstract] Objective: To systematically evaluate the efficacy and safety of azithromycin in the adjuvant treatment of bronchial asthma in children. Methods: PubMed, Medline, EMBASE, Cochrane library, CNKI, CBM, Wanfang database and VIP database were retrieved, the retrieval time was from the database establishment to Sept. 30th, 2017, and 10 randomized controlled trials (RCT) were obtained. The quality of the literature was evaluated according to the Cochrane Reviewers’ Handbook. All subjects were divided into the azithromycin group and the control group (no azithromycin was used). Outcome indicators were the frequency of acute asthma attacks, the number of application times of relief drugs, the asthma quality of life questionnaire (AQLQ) score, the asthma control questionnaire (ACQ) score, the lung function indicators and the incidence of adverse drug reactions. RevMan software was used for Meta analysis. Results: Meta analysis was conducted on 10 included clinical RCT (n=1060), the results showed that: (1) There was no significant difference in the frequency of acute asthma attacks between the azithromycin group and the control group (P>0.05). Subgroup analysis showed that there was statistically significant difference in the frequency of acute asthma attacks in non-eosinophil patients between two groups (P=0.01), while there was no statistically significant difference in the frequency of acute asthma attacks in non-eosinophil patients between two groups (P=0.95). (2) There was no significant difference in the number of application times of relief drugs between the azithromycin group and the control group (P>0.05). (3) There was no significant difference in the AQLQ (P>0.05) and ACQ (P>0.05) between the azithromycin group and the control group. (4) There were significant differences in PEF (P<0.01) and FEV1 (P<0.01) between the azithromycin group and the control group. (5) There were significant differences in nausea (P<0.01) and diarrhea (P<0.01) between the azithromycin group and the control group. Conclusion: Azithromycin can prevent the acute attacks of patients with persistent asthma and improve PEF and FEV1% levels in asthma patients. However, there is no significant effect in reducing the application of asthma drugs and improving the quality of life. Long-term application of azithromycin may increase gastrointestinal reactions such as nausea and diarrhea, and there are no other serious adverse drug reactions. |
| Key words: azithromycin bronchial asthma acute attacks Meta analysis |
