布地奈德雾化吸入辅助治疗国内小儿肺炎疗效的Meta分析

Meta-analysis of Adjuvant Therapy of Aerosol Inhalation of Budesonide in the Treatment of Children Pneumonia

目的:系统评价布地奈德雾化吸入辅助治疗国内小儿肺炎的疗效。方法:全面检索中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊全文数据库、万方数字化期刊全文库,纳入在常规治疗基础上加用布地奈德雾化吸入治疗小儿肺炎的随机对照试验(RCT),并对纳入RCT进行方法学质量评价和Meta分析。结果:共纳入11个RCT,1370例患儿。方法学方面可能存在一定选择偏倚、实施偏倚风险。Meta分析结果显示,布地奈德组在治愈、症状消失时间、住院时间指标等方面都优于常规治疗组,并且差异有统计学意义:治愈[RR=1.57,95%C(I1.36,1.81)]、发热消失时间[MD=-1.57,95%C(I-2.31,-0.83)]、咳嗽消失时间[MD=-2.48,95%C(I-3.11,-1.85)]、肺部音消失时间[MD=-1.25,95%C(I-1.95,-0.56)]、住院时间[MD=-3.71,95%C(I-4.83,-2.59)]。结论:基于目前国内临床证据,在常规治疗基础上加用布地奈德雾化吸入,有利于小儿肺炎治疗。

OBJECTIVE：To evaluate the adjuvant therapy of aerosol inhalation of budesonide in the treatment of children pneumonia in China systematically. METHODS： Retrieved from CBM, CNKI, VIP and Wanfang database, randomized controlled trials of adjuvant therapy of aerosol inhalation of budesonide in the treatment of children pneumonia in China were included. The quality of included studies was evaluated and Meta-analysis was conducted. RESULTS： A total of 11 studies（1 370 cases） were included, the selection bias and performance bias risk might affect the study. Meta-analysis results indicated that the recovery, symptom disappearing time and hospitalization time in budesonide group were better than control group, there was significant difference： recovery rate [RR=1.57, 95%CI（1.36,1.81）], fever disappearing time [MD=-1.57,95%CI（-2.31,-0.83）], cough disappearing time [MD=-2.48,95%CI（-3.11,-1.85）], bellows rales disappearing time [MD=-1.25,95%CI（-1.95,-0.56）] and hospitalization time [MD=-3.71,95%CI（-4.83,-2.59）]. CONCLUSION： Based on recent evidence in China, aerosol inhalation of budesonide combined with conventional therapy contributes to the treatment of children pneumonia.