孟鲁司特钠联合酮替芬治疗中国患儿咳嗽变异性哮喘疗效和安全性的Meta分析

Efficacy and safety of montelukast sodium combined with ketotifen in Chinese children with cough variant asthma:a Meta-analysis

目的系统评价孟鲁司特钠联合酮替芬治疗患儿咳嗽变异性哮喘的有效性和安全性。方法计算机检索Ovid Embase、Medline、Cochrane library、CNKI、VIP、CBM和Wanfang数据库,对符合纳入排除标准的随机对照试验进行数据提取和偏倚风险评价,然后采用RevMan 5.3软件进行Meta分析。结果最终纳入9个随机对照试验,共778例患者。Meta分析结果显示:在总有效率(RR=1.29,95%CI:1.21~1.38;P<0.01)、显效率(RR=1.66,95%CI:1.43~1.93;P<0.01)和复发率(RR=0.35,95%CI:0.20~0.64;P<0.01)方面,试验组均优于对照组;试验组的咳嗽缓解时间(MD=-1.39,95%CI:-1.56^-1.23;P<0.01)和咳嗽消失时间(MD=-2.86,95%CI:-3.92^-1.79;P<0.01)少于对照组,差异均具有统计学意义,但2组患儿的不良反应发生率相当(RR=0.91,95%CI:0.52~1.59;P=0.73)。结论基于目前临床证据,孟鲁司特钠联合酮替芬可有效治疗患儿咳嗽变异性哮喘,改善患儿的咳嗽症状。

ObjectiveTo systematically evaluate the efficacy and safety of montelukast sodium combined with ketotifen in children with cough variant asthma. MethodsThe databases of Ovid Embase,Medline,Cochrane library,CNKI,VIP,CBM and Wanfang were searched.Data extraction and quality assessment were performed for RCTs,and then the meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 9 RCTs involving 778 patients were included.The results of Meta-analysis showed that compared with control group,trial group were significantly higher in overall response rate(RR=1.29,95%CI:1.21~1.38;P<0.01)and marked improvement rate(RR=1.66,95%CI:1.43~1.93;P<0.01),as well as significantly lower in recurrence rate(RR=0.35,95%CI:0.20~0.64;P<0.01). The cough relief time(MD=-1.39,95%CI:-1.56^-1.23;P<0.01)and cough disappearance time(MD=-2.86,95%CI:-3.92^-1.79;P<0.01)of trial group were significantly shorter than control group.There was no statistically significant difference in incidence of adverse drug reaction between two groups(RR=0.91,95%CI:0.52~1.59;P=0.73). ConclusionAccording to the current evidence,montelukast sodium combined with ketotifen has a significant effect in children with cough variant asthma and can improve cough symptoms.