PDF(Pubmed)
Abstract：
UNASSIGNED: Lianhua Qingwen (LHQW) granule, a botanical drug preparation, is frequently utilized as an adjuvant treatment for mycoplasma pneumoniae pneumonia (MPP). Nevertheless, the clinical efficacy and safety of this treatment remain uncertain.
UNASSIGNED: This study aims to evaluate the efficacy and safety of LHQW granule combined with azithromycin (AZM) in treating MPP in children.
UNASSIGNED: To identify all randomized controlled trials (RCTs) of LHQW granule plus AZM, a search was conducted in eight Chinese and English databases (CNKI, Wan Fang, VIP, Sinomed, PubMed, Embase, Web of Science, and Cochrane Library) from their inception until 25 December 2023. Meta-regression and subgroup analysis were employed to investigate heterogeneity. Sensitivity analysis and trial sequential analysis (TSA) were conducted to assess the robustness of the findings. Additionally, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was utilized to evaluate the quality of evidence.
UNASSIGNED: A total of 15 RCTs involving 1909 participants were included in this study. The meta-analysis results indicated combination therapy of LHQW granule and AZM is significant different from AZM alone in both efficacy and safety, which are specifically observed in the following outcomes: response rate (RR = 1.17, 95% CI: 1.12 to 1.22, p < 0.01), antipyretic time (MD = -1.32, 95% CI: -1.66 to -0.98, p < 0.01), cough disappearance time (MD = -1.76, 95% CI: -2.47 to -1.05, p < 0.01), pulmonary rale disappearance time (MD = -1.54, 95% CI: -2.06 to -1.02, p < 0.01), c-reactive protein (CRP) (MD = -5.50, 95% CI: -6.92 to -4.07, p < 0.01), procalcitonin (PCT) (MD = -0.31, 95% CI: -0.38 to -0.24, p < 0.01), interleukin 6 (IL-6) (MD = -5.97, 95% CI: -7.39 to -4.54, p<0.01), tumor necrosis factor α (TNF-α) (MD = -5.74, 95% CI: -7.44 to -4.04, p < 0.01), forced vital capacity (FVC) (SMD = 0.48, 95% CI: 0.34 to 0.62, p < 0.01), forced expiratory volume in the first second (FEV1) (SMD = 0.55, 95% CI: 0.44 to 0.67, p < 0.01), FEV1/FVC (SMD = 0.49, 95% CI: 0.32 to 0.67, p < 0.01), CD4+ T lymphocyte (CD4+) (MD = 4.04, 95% CI: 3.09 to 4.98, p < 0.01), CD8+ T lymphocyte (CD8+) (MD = -3.32, 95% CI: 4.27 to 2.38, p < 0.01) and adverse events (RR = 0.65, 95% CI: 0.43 to 0.96, p < 0.01).
UNASSIGNED: The combination therapy of LHQW granule and AZM may be a better strategy to treat MPP in children. However, the clinical efficacy and safety of LHQW granule require further validation.
UNASSIGNED: https://www.crd.york.ac.uk/PROSPERO/.
UNASSIGNED: This study aims to evaluate the efficacy and safety of LHQW granule combined with azithromycin (AZM) in treating MPP in children.
UNASSIGNED: To identify all randomized controlled trials (RCTs) of LHQW granule plus AZM, a search was conducted in eight Chinese and English databases (CNKI, Wan Fang, VIP, Sinomed, PubMed, Embase, Web of Science, and Cochrane Library) from their inception until 25 December 2023. Meta-regression and subgroup analysis were employed to investigate heterogeneity. Sensitivity analysis and trial sequential analysis (TSA) were conducted to assess the robustness of the findings. Additionally, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was utilized to evaluate the quality of evidence.
UNASSIGNED: A total of 15 RCTs involving 1909 participants were included in this study. The meta-analysis results indicated combination therapy of LHQW granule and AZM is significant different from AZM alone in both efficacy and safety, which are specifically observed in the following outcomes: response rate (RR = 1.17, 95% CI: 1.12 to 1.22, p < 0.01), antipyretic time (MD = -1.32, 95% CI: -1.66 to -0.98, p < 0.01), cough disappearance time (MD = -1.76, 95% CI: -2.47 to -1.05, p < 0.01), pulmonary rale disappearance time (MD = -1.54, 95% CI: -2.06 to -1.02, p < 0.01), c-reactive protein (CRP) (MD = -5.50, 95% CI: -6.92 to -4.07, p < 0.01), procalcitonin (PCT) (MD = -0.31, 95% CI: -0.38 to -0.24, p < 0.01), interleukin 6 (IL-6) (MD = -5.97, 95% CI: -7.39 to -4.54, p<0.01), tumor necrosis factor α (TNF-α) (MD = -5.74, 95% CI: -7.44 to -4.04, p < 0.01), forced vital capacity (FVC) (SMD = 0.48, 95% CI: 0.34 to 0.62, p < 0.01), forced expiratory volume in the first second (FEV1) (SMD = 0.55, 95% CI: 0.44 to 0.67, p < 0.01), FEV1/FVC (SMD = 0.49, 95% CI: 0.32 to 0.67, p < 0.01), CD4+ T lymphocyte (CD4+) (MD = 4.04, 95% CI: 3.09 to 4.98, p < 0.01), CD8+ T lymphocyte (CD8+) (MD = -3.32, 95% CI: 4.27 to 2.38, p < 0.01) and adverse events (RR = 0.65, 95% CI: 0.43 to 0.96, p < 0.01).
UNASSIGNED: The combination therapy of LHQW granule and AZM may be a better strategy to treat MPP in children. However, the clinical efficacy and safety of LHQW granule require further validation.
UNASSIGNED: https://www.crd.york.ac.uk/PROSPERO/.
摘要：
■连花清温（LHQW）颗粒，植物药物制剂，经常用作肺炎支原体肺炎（MPP）的辅助治疗。然而，该治疗的临床疗效和安全性仍不确定.
■本研究旨在评估LHQW颗粒联合阿奇霉素（AZM）治疗儿童MPP的疗效和安全性。
■为了确定LHQW颗粒加AZM的所有随机对照试验（RCT），在八个中文和英文数据库中进行了搜索(CNKI，万芳,VIP,Sinomed,PubMed,Embase,WebofScience,和Cochrane图书馆）从成立到2023年12月25日。采用Meta回归和亚组分析研究异质性。进行敏感性分析和试验序贯分析(TSA)以评估结果的稳健性。此外,建议评估的等级，利用开发和评估（GRADE）系统评估证据质量。
■本研究共纳入15项RCT，涉及1909名参与者。荟萃分析结果表明，LHQW颗粒与AZM联合治疗在疗效和安全性上与单纯AZM有显著差异。在以下结果中具体观察到：反应率（RR=1.17，95%CI：1.12至1.22，p<0.01），退热时间（MD=-1.32，95％CI：-1.66至-0.98，p<0.01），咳嗽消失时间（MD=-1.76，95%CI：-2.47至-1.05，p<0.01），肺部啰音消失时间（MD=-1.54，95％CI：-2.06至-1.02，p<0.01），C反应蛋白（CRP）（MD=-5.50，95％CI：-6.92至-4.07，p<0.01），降钙素原（PCT）（MD=-0.31，95％CI：-0.38至-0.24，p<0.01），白细胞介素6（IL-6）（MD=-5.97，95％CI：-7.39至-4.54，p<0.01），肿瘤坏死因子α（TNF-α）（MD=-5.74，95％CI：-7.44至-4.04，p<0.01），强迫肺活量（FVC）（SMD=0.48，95%CI：0.34至0.62，p<0.01），第一秒用力呼气量（FEV1）（SMD=0.55，95％CI：0.44至0.67，p<0.01），FEV1/FVC（SMD=0.49，95%CI：0.32至0.67，p<0.01），CD4+T淋巴细胞(CD4+)(MD=4.04,95%CI:3.09~4.98,p<0.01),CD8+T淋巴细胞(CD8+)(MD=-3.32,95%CI：4.27~2.38,p<0.01)和不良事件(RR=0.65,95%CI：0.43~0.96,p<0.01)。
■LHQW颗粒联合AZM可能是治疗儿童MPP的更好策略。然而,LHQW颗粒的临床疗效和安全性需要进一步验证.
■https://www.crd.约克。AC.英国/PROSPERO/。
■本研究旨在评估LHQW颗粒联合阿奇霉素（AZM）治疗儿童MPP的疗效和安全性。
■为了确定LHQW颗粒加AZM的所有随机对照试验（RCT），在八个中文和英文数据库中进行了搜索(CNKI，万芳,VIP,Sinomed,PubMed,Embase,WebofScience,和Cochrane图书馆）从成立到2023年12月25日。采用Meta回归和亚组分析研究异质性。进行敏感性分析和试验序贯分析(TSA)以评估结果的稳健性。此外,建议评估的等级，利用开发和评估（GRADE）系统评估证据质量。
■本研究共纳入15项RCT，涉及1909名参与者。荟萃分析结果表明，LHQW颗粒与AZM联合治疗在疗效和安全性上与单纯AZM有显著差异。在以下结果中具体观察到：反应率（RR=1.17，95%CI：1.12至1.22，p<0.01），退热时间（MD=-1.32，95％CI：-1.66至-0.98，p<0.01），咳嗽消失时间（MD=-1.76，95%CI：-2.47至-1.05，p<0.01），肺部啰音消失时间（MD=-1.54，95％CI：-2.06至-1.02，p<0.01），C反应蛋白（CRP）（MD=-5.50，95％CI：-6.92至-4.07，p<0.01），降钙素原（PCT）（MD=-0.31，95％CI：-0.38至-0.24，p<0.01），白细胞介素6（IL-6）（MD=-5.97，95％CI：-7.39至-4.54，p<0.01），肿瘤坏死因子α（TNF-α）（MD=-5.74，95％CI：-7.44至-4.04，p<0.01），强迫肺活量（FVC）（SMD=0.48，95%CI：0.34至0.62，p<0.01），第一秒用力呼气量（FEV1）（SMD=0.55，95％CI：0.44至0.67，p<0.01），FEV1/FVC（SMD=0.49，95%CI：0.32至0.67，p<0.01），CD4+T淋巴细胞(CD4+)(MD=4.04,95%CI:3.09~4.98,p<0.01),CD8+T淋巴细胞(CD8+)(MD=-3.32,95%CI：4.27~2.38,p<0.01)和不良事件(RR=0.65,95%CI：0.43~0.96,p<0.01)。
■LHQW颗粒联合AZM可能是治疗儿童MPP的更好策略。然而,LHQW颗粒的临床疗效和安全性需要进一步验证.
■https://www.crd.约克。AC.英国/PROSPERO/。
