孟鲁司特钠联合双歧杆菌四联活菌治疗儿童过敏性紫癜有效性Meta分析

Efficacy of Montelukast Sodium Combined with Bifidobacterium Tetra Viable Tablets in the Treatment of Children with Henoch-Sch nlein Purpura:A Meta-analysis

目的研究评价孟鲁司特钠联合双歧杆菌四联活菌治疗儿童过敏性紫癜的有效性。方法检索Pubmed、Cochrane Library、Embase、中国知网、万方数据库、中国生物医学数据库、维普数据库关于孟鲁司特钠联合双歧杆菌四联活菌治疗儿童过敏性紫癜(HSP)的随机对照实验,检索时限均为各数据库建库起始至2021年12月21日。筛选文献、提取资料并采用Cochrane Handbook 6.0对纳入文献进行质量评价后,采用Stata 11.0进行分析。结果共纳入13个研究1038名HSP患儿。Meta分析结果表明孟鲁司特钠联合双歧杆菌四联活菌组在总有效率、临床症状缓解(皮肤紫癜缓解、关节肿痛缓解、腹痛缓解)以及实验室指标(IgA、C3、Alb、β2MG)方面均优于常规治疗组。结论现阶段低质量的研究不应该作为现阶段孟鲁司特钠联合双歧杆菌四联活菌治疗儿童过敏性紫癜的循证依据,临床药师应该积极干预。孟鲁司特钠联合双歧杆菌四联活菌疗效及安全性评价仍需要大样本、多中心、高质量RCT研究证实。

OBJECTIVE To assess the efficacy of montelukast sodium combined with bifidobacterium tetra viable tablets in the treatment of children with Henoch-Schonlein purpura(HSP).METHODS The Pubmed,Cochrane Library,Embase,CNKI,Wanfang Database,CBMdisc,and VIP Database were searched from the earliest record date to Dec.21,2021.Randomized clinical trials for HSP in pediatric patients were included in the Meta-analysis.After literatures screening and data extracting,the quality of the included studies was examined in accordance with the Cochrane Handbook 6.0,and the data was performed the Meta-analysis with Stata 11.0.RESULTS Thirteen studies were ultimately included,involving a total of 1038 subjects.This meta-analysis revealed that the total effective rate,relief of symptoms(skin purpura,joint swelling and abdominal pain)and laboratory findings(IgA,C3,Alb andβ2MG)of the subjects in the experimental group were better than that of subjects in the control group.CONCLUSION Because of these low-quality original studies provided inferior quality of evidence to support the efficacy of montelukast sodium combined with bifidobacterium tetra viable tablets in the treatment of children with HSP,clinical pharmacists should actively intercept it.Of course,the efficacy and the safety need more confirmation in high-grade controlled randomized trials employing a large sample size,and multi-center dataset.