背景:热毒宁(RDN)注射液是一种众所周知的中药(TCM)制剂,可用作抗生素的替代品,具有协同和减毒作用。在中国,RDN广泛应用于感染性疾病的联合治疗。
目的:评价RDN联合阿奇霉素(AZM)治疗儿童支原体肺炎(MP)的临床疗效,并确定其安全性。为临床治疗提供循证参考。
方法:搜索了八个数据库,包括4个英语数据库,即,PubMed,EMBASE,Cochrane图书馆,和WebofScience,和4个中文数据库,即,中国国家知识基础设施(CNKI),万方,中国科技期刊数据库(CQVIP),还有Sino-Med.纳入RDN联合AZM治疗小儿MP患者的随机对照试验(RCTs)。从每个数据库开始到2022年4月25日进行全面搜索。
结果:共纳入20项研究,涵盖1628名儿童。Meta分析显示临床有效率(RR=1.20,95%CI[1.15,1.26],I2=0%),咳嗽消失的时间(MD=-2.04,95%CI[-2.67,-1.41],I2=91%),直到肺部啰音消失的时间(MD=-2.55,95%CI[-3.12,-1.98],I2=95%),直到发热缓解的时间(MD=-1.93,95%CI[-2.37,-1.49],I2=92%),治疗后TNF-α水平(SMD=-1.17,95%CI[-1.96,-0.39],I2=97%),治疗后IL-6水平(SMD=-2.65,95%CI[-3.51,-1.78],I2=97%)联合治疗MPP优于其他方法,和不良反应发生率(RR=0.75,95%CI[0.56,1.00],I2=0%)显示出统计学上的显著差异。
结论:RDN联合AZM治疗儿童MP的临床疗效提高,安全性高。
BACKGROUND: Reduning (RDN) injection is a well-known traditional Chinese medicine (TCM) preparation that can be used as an alternative to antibiotics with synergistic and toxicity-reducing effects. In China, RDN is widely used in the combined treatment of infectious diseases.
OBJECTIVE: To evaluate the clinical efficacy of RDN combined with azithromycin (AZM) for the treatment of mycoplasma pneumonia (MP) among children and to determine its safety, providing an evidence-based reference for clinical treatment.
METHODS: Eight databases were searched, including 4 English databases, namely, PubMed, EMBASE, the Cochrane Library, and Web of Science, and 4 Chinese databases, namely, China National Knowledge Infrastructure (CNKI), Wanfang, China Science and Technology Journal Database (CQVIP), and Sino-Med. Randomized controlled trials (RCTs) were included in which RDN was combined with AZM for the treatment of MP pediatric patients. A comprehensive search was performed from the inception of each database until April 25, 2022.
RESULTS: A total of 20 studies covering 1628 children were included. Meta-analysis showed that the clinical effectiveness rate (RR = 1.20, 95% CI [1.15, 1.26], I2 = 0%), time elapsed until disappearance of cough (MD = -2.04, 95% CI [-2.67, -1.41], I2 = 91%), time elapsed until disappearance of lung rales (MD = -2.55, 95% CI [-3.12, -1.98], I2 = 95%), time elapsed until reduction of fever (MD = -1.93, 95% CI [-2.37, -1.49], I2 = 92%), TNF-α level after treatment (SMD = -1.17, 95% CI [-1.96, -0.39], I2 = 97%), and IL-6 levels after treatment (SMD = -2.65, 95% CI [-3.51, -1.78], I2 = 97%) of the combined treatment of MPP were superior to those of other methods, and incidence of adverse reactions (RR = 0.75, 95% CI [0.56, 1.00], I2 = 0%) showed statistically significant differences.
CONCLUSIONS: RDN combined with AZM for the treatment of MP among children results in increased clinical efficacy with high safety.