孟鲁司特钠治疗婴幼儿毛细支气管炎疗效的Meta分析

Efficacy of Montelukast Sodium in Treatment of Infants Bronchiolitis:A Meta-Analysis

目的系统评估孟鲁司特钠治疗婴幼儿毛细支气管炎的有效性。方法电子检索CNKI、VIP、Wanfang、Embase、The Cochrane Library、PubMed、中国和美国临床试验注册中心数据库,搜集孟鲁司特钠与常规治疗或安慰剂比较治疗婴幼儿毛细支气管炎的随机对照试验(RCT),检索时间从建库至2019年5月。两名作者独自完成文献筛选,提取资料和质量评价。采用RevMan 5.3和Stata 12.0软件进行Meta分析。结果共纳入16项研究,共1549例患儿。Meta分析结果显示,与对照组相比,试验组能缩短咳嗽消失时间(MD=-2.16 d,95%CI-2.52 d^-1.79 d,P<0.00001)、喘息缓解时间(MD=-1.92 d,95%CI-2.86 d^-0.99 d,P<0.0001)、肺部体征消失时间(MD=-2.35 d,95%CI-3.23 d^-1.48 d,P<0.00001)、住院时间(SMD=-0.91,95%CI-1.28^-0.54,P<0.00001),且两组不良反应发生率比较差异无统计学意义(P>0.05),但不能降低病情严重程度。结论孟鲁司特钠治疗毛细支气管炎的临床疗效显著,且不增加不良反应。但受样本量、研究质量等限制,需进一步开展大规模、高质量临床RCT加以验证。

Objective To systematically assess the efficacy of montelukast sodium in the treatment of infantile bronchiolitis.Methods Databases including VIP,Wanfang,PubMed,Embase,The Cochrane Library,CNKI,Chinese Clinical Trial Registry and Clinical Trials gov were searched from inception to May 2019 to collect randomized controlled trials(RCT)about montelukast sodium for bronchiolitis in infants.Two reviewers independently screened literatures,extracted data and assessed the risk of bias of the included studies.Then,Meta-analysis was performed using RevMan 5.3 and Stata 12.0 software.Results A total of 16 RCTs,involving 1549 patients were included.The results of Meta-analysis showed that,compared with the control group,the experiment group had shorter cough disappearance time(MD=-2.16 d,95%CI-2.52 d--1.79 d,P<0.00001),asthmatic relief time(MD=-1.92 d,95%CI-2.86 d--0.99 d,P<0.0001),pulmonary symptom disappearance time(MD=-2.35 d,95%CI-3.23 d--1.48 d,P<0.00001)and average hospitalization time(SMD=-0.91,95%CI-1.28--0.54,P<0.00001).There were no significant difference in adverse reactions rate between the two groups(P>0.05).Conclusion The montelukast sodium in the treatment of bronchiolitis achieves the satisfactory clinical efficacy,without adding adverse reactions.However,due to the limited quantity and quality of included studies,larger sample and high quality RCT are needed for verification.