雾化吸入硫酸镁联合沙丁胺醇治疗儿童哮喘有效性和安全性的meta分析

Meta-analysis of the effectiveness and safety of nebulized inhaled magnesium sulfate combined with salbutamol in the treatment of asthma in children

目的对雾化吸入硫酸镁联合沙丁胺醇治疗儿童哮喘的疗效和安全性进行meta分析,为临床治疗该疾病患儿提供循证医学证据。方法检索建库起至2021年7月PubMed、Cochrane Library、Embase、中国知网、万方数据库、维普中文期刊数据库、中国生物医学文献数据库,收集雾化硫酸镁联合沙丁胺醇(试验组)与雾化沙丁胺醇(对照组)治疗儿童哮喘的随机对照试验(RCT)。按照制订的纳入与排除标准进行文献筛选,提取数据并依据Cochrane偏倚风险评估表评价纳入研究的质量,采用RevMan 5.3软件进行meta分析。结果本研究共纳入14项RCT,共1198例患者。meta分析结果显示,试验组患者临床总有效率[RR=1.15,95%CI:(1.09,1.20),P<0.00001]、第一秒用力呼气容积[MD=0.10,95%CI:(-0.02,0.18),P=0.02]、呼气流量峰值[MD=0.38,95%CI:(0.26,0.49),P<0.00001]高于对照组,差异有统计学意义。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论雾化吸入硫酸镁联合沙丁胺醇能有效提高哮喘患儿的临床疗效、改善肺功能各项指标,其安全性与单用沙丁胺醇相当。

Objective To provide evidence-based medical evidence for the clinical treatment of children with this disease through a meta-analysis of the efficacy and safety of nebulized inhaled magnesium sulfate in combination with salbutamol in the treatment of childhood asthma.Methods The randomized controlled trials(RCTs)of nebulized magnesium sulfate combined with salbutamol(trial group)and nebulized salbutamol(control group)for the treatment of asthma in children were collected by searching PubMed,Cochrane Library,Embase,China Knowledge Network,Wanfang database,VIP Chinese journal database,and Chinese biomedical literature database from the establishment of the database to July 2021.The RCTs were screened according to the established inclusion and exclusion criteria,data were extracted and the quality of included studies was evaluated according to the Cochrane risk of bias assessment scale,and meta-analysis was performed using RevMan 5.3 software.Results A total of 14 RCTs with a total of 1198 patients were included in this study.The results of meta-analysis showed that the total clinical efficiency(RR=1.15,95%CI:[1.09,1.20],P<0.00001),forced expiratory volume in first second(MD=0.10,95%CI:[-0.02,0.18],P=0.02),and peak expiratory flow(MD=0.38,95%CI:[0.26,0.49],P<0.00001)in the trial group were higher than those in the control group,and the differences were statistically significant.There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Nebulized inhalation of magnesium sulfate combined with salbutamol can effectively improve the clinical efficacy and lung function indexes of children with asthma,and its safety is comparable to that of salbutamol alone.