中西医结合治疗小儿肺炎支原体肺炎效果的Meta分析

Efficacy of combination therapy of mycoplasma pneumonia： a Meta analysis

目的 评价中西医结合治疗小儿肺炎支原体肺炎的临床效果.方法 收集国内关于中西医结合治疗和单纯西医治疗小儿肺炎支原体肺炎的随机对照研究文献,对结果进行Meta分析.其中,试验组进行中西医结合治疗,在应用抗生素的基础上服用各式中药煎剂;对照组进行抗生素治疗.疗效及差异评价指标以比值比（OR）、加权均数差（WMD）和95％置信区间（CI）表示.统计学分析采用Revman 2.8软件.结果 共收集国内20个随机对照研究,Meta分析结果显示：2组病例治疗后均得到明显改善,试验组痊愈率和显效率明显优于对照组,差异有统计学意义（OR=2.92,95％ CI：2.29 ～3.74,P＜0.01）;试验组无效率低于对照组,差异有统计学意义（OR =0.20,95％CI：0.12 ～0.34,P＜0.01）;比较2组病例的啰音消失时间、咳嗽消失时间、退热时间,试验组能在相对较短时间内使各指标恢复正常,差异有统计学意义,3者Meta分析值分别为：（WMD=-2.22,95％CI：-2.43～-2.01,P＜0.01）、（WMD=-1.61,95％ CI：-2.35～-0.86,P＜0.01）、（WMD=-0.90,95％ CI：-1.43 ～-0.37,P＜0.01）;试验组不良反应发生率低于对照组,差异有统计学意义（OR =0.16,95％ CI：0.05 ～0.48,P=0.01）.结论 中西医结合治疗小儿肺炎支原体肺炎疗效优于单纯西医治疗.

Objective To discuss the clinical efficacy of Chinese and Western medicine inmycoplasma pneumonia in children.Methods Randomized controlled trials （RCTs） on western medicine versus traditional Chinese combined with Western medicine treating children mycoplasma pneumonia were identified according to the inclusion and exclusion criteria.Methodological quality of included studies was accessed.Meta-analysis was then performed using RevMan 4.2 software.Pooled odds ratio （OR）,weighted mean difference （WMD） and 95% confidence interval （CI） were calculated.20 randomized controlled domestic researches were gathered.Results Cure rate and effective rate in the experimental group were better than those in the control group（OR =2.92,95% CI：2.29 to 3.74,P 〈0.01）.Inefficiency in the experimental group was lower than in control group; the difference was statistically significant （OR =0.20,95% CI：0.12 to 0.34,P 〈 0.01） ; rale disappearance time,cough disappearance time and cooling time in the experimental group were shorter than those in control group（WMD =-2.22,95% CI：-2.43 to-2.01,P〈0.01）,（WMD =-1.61,95% CI：-2.35 to-0.86,P〈0.01）,（OR=-0.90,95% CI：-1.43 to-0.37,P =0.0008）.The incidence of adverse reactions in the experimental group was lower than that in the control group; the difference was statistically significant,（WMD =0.16,95% CI：0.05 to 0.48,P =0.001）.Conclusion Treatment of mycoplasma pneumonia in children with Chinese and Western Medicine can significantly increase the efficiency of recovery; the non-efficiency and the incidence of adverse reactions can be significantly reduced.