PDF(Pubmed)
Abstract：
BACKGROUND: Budesonide, capable of reducing vascular permeability, suppressing mucus secretion, and alleviating edema and spasms, is widely used in China for combined infectious disease treatment. This study assesses budesonide\'s efficacy and safety as an adjunct to azithromycin in pediatric Mycoplasma pneumonia management in China, aiming to establish a strong theoretical foundation for its clinical application.
METHODS: We conducted a comprehensive search for qualifying studies across 5 English databases and 4 Chinese databases, covering publications until October 31, 2023. Endpoint analyses were performed using standard software (Stata Corporation, College Station, TX). This study was conducted in compliance with the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
RESULTS: A total of 24 randomized controlled trials were involved in the current study, including 2034 patients. Our findings indicate that the combination of budesonide with azithromycin for the treatment of pediatric Mycoplasma pneumonia delivers superior therapeutic efficacy (Intravenous: odds ratio [OR], 0.156, P < .001; Sequential: OR, 0.163, P = .001; Oral: OR, 0.139, P < .001), improved pulmonary function (Forced expiratory volume in 1 second: weighted mean differences [WMD], -0.28, P = .001; Peak expiratory flow: WMD, -0.554, P = .002; Forced vital capacity: WMD, -0.321, P < .001), diminished lung inflammation (IL-6: WMD, 4.760, P = .002; c-reactive protein: WMD, 5.520, P < .001; TNF-α: WMD, 9.124, P < .001), reduced duration of fever, faster resolution of cough and rales, all without increasing the occurrence of adverse events.
CONCLUSIONS: The combination of budesonide and azithromycin demonstrates enhanced therapeutic effectiveness, promotes improved pulmonary function, shortens the duration of symptoms, and effectively mitigates the overexpression of inflammatory factors like c-reactive protein, TNF-α, and IL-6, all without an associated increase in adverse reactions in pediatric mycoplasma pneumonia.
METHODS: We conducted a comprehensive search for qualifying studies across 5 English databases and 4 Chinese databases, covering publications until October 31, 2023. Endpoint analyses were performed using standard software (Stata Corporation, College Station, TX). This study was conducted in compliance with the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
RESULTS: A total of 24 randomized controlled trials were involved in the current study, including 2034 patients. Our findings indicate that the combination of budesonide with azithromycin for the treatment of pediatric Mycoplasma pneumonia delivers superior therapeutic efficacy (Intravenous: odds ratio [OR], 0.156, P < .001; Sequential: OR, 0.163, P = .001; Oral: OR, 0.139, P < .001), improved pulmonary function (Forced expiratory volume in 1 second: weighted mean differences [WMD], -0.28, P = .001; Peak expiratory flow: WMD, -0.554, P = .002; Forced vital capacity: WMD, -0.321, P < .001), diminished lung inflammation (IL-6: WMD, 4.760, P = .002; c-reactive protein: WMD, 5.520, P < .001; TNF-α: WMD, 9.124, P < .001), reduced duration of fever, faster resolution of cough and rales, all without increasing the occurrence of adverse events.
CONCLUSIONS: The combination of budesonide and azithromycin demonstrates enhanced therapeutic effectiveness, promotes improved pulmonary function, shortens the duration of symptoms, and effectively mitigates the overexpression of inflammatory factors like c-reactive protein, TNF-α, and IL-6, all without an associated increase in adverse reactions in pediatric mycoplasma pneumonia.
摘要：
背景：布地奈德，能够降低血管通透性，抑制粘液分泌，减轻水肿和痉挛，在中国被广泛用于合并传染病的治疗。这项研究评估了布地奈德作为阿奇霉素辅助治疗中国小儿支原体肺炎的疗效和安全性。旨在为其临床应用奠定坚实的理论基础。
方法：我们在5个英文数据库和4个中文数据库中对合格研究进行了全面搜索，涵盖出版物，直至2023年10月31日。使用标准软件(StataCorporation，学院站,TX）。这项研究是按照系统评价和荟萃分析的首选报告项目中概述的指南进行的。
结果：本研究共涉及24项随机对照试验，包括2034名患者。我们的发现表明，布地奈德与阿奇霉素联合治疗小儿支原体肺炎可获得更好的治疗效果（静脉：比值比[OR]，0.156，P<.001；顺序：OR，0.163，P=.001；口服：OR，0.139，P<.001)，改善肺功能(1秒用力呼气量：加权平均差[WMD]，-0.28，P=.001；最大呼气流量：大规模杀伤性武器，-0.554，P=.002；强迫肺活量：大规模杀伤性武器，-0.321,P<.001),肺部炎症减少（IL-6：WMD，4.760，P=0.002；C反应蛋白：WMD，5.520，P<.001；TNF-α：WMD，9.124,P<.001),减少发烧的持续时间，更快的咳嗽和啰音的解决，所有这些都没有增加不良事件的发生。
结论：布地奈德和阿奇霉素的联合使用显示出更高的治疗效果，促进改善肺功能，缩短症状持续时间，有效减轻C反应蛋白等炎症因子的过度表达,TNF-α,和IL-6，均未增加小儿支原体肺炎的不良反应。
方法：我们在5个英文数据库和4个中文数据库中对合格研究进行了全面搜索，涵盖出版物，直至2023年10月31日。使用标准软件(StataCorporation，学院站,TX）。这项研究是按照系统评价和荟萃分析的首选报告项目中概述的指南进行的。
结果：本研究共涉及24项随机对照试验，包括2034名患者。我们的发现表明，布地奈德与阿奇霉素联合治疗小儿支原体肺炎可获得更好的治疗效果（静脉：比值比[OR]，0.156，P<.001；顺序：OR，0.163，P=.001；口服：OR，0.139，P<.001)，改善肺功能(1秒用力呼气量：加权平均差[WMD]，-0.28，P=.001；最大呼气流量：大规模杀伤性武器，-0.554，P=.002；强迫肺活量：大规模杀伤性武器，-0.321,P<.001),肺部炎症减少（IL-6：WMD，4.760，P=0.002；C反应蛋白：WMD，5.520，P<.001；TNF-α：WMD，9.124,P<.001),减少发烧的持续时间，更快的咳嗽和啰音的解决，所有这些都没有增加不良事件的发生。
结论：布地奈德和阿奇霉素的联合使用显示出更高的治疗效果，促进改善肺功能，缩短症状持续时间，有效减轻C反应蛋白等炎症因子的过度表达,TNF-α,和IL-6，均未增加小儿支原体肺炎的不良反应。
