这项荟萃分析旨在评估孟鲁司特钠联合治疗儿童咳嗽变异性哮喘(CVA)的临床疗效。旨在提供临床证据和数据,指导临床治疗方案的选择。使用许多数据库进行了文献综述,包括中国国家知识基础设施(CNKI),万方数据库,Embase,PubMed,和WebofScience,从成立到2023年12月。纳入符合孟鲁司特钠联合治疗儿童CVA标准的试验。采用Stata16.0软件进行Meta分析。联合治疗组在对照组基础上加用孟鲁司特钠,而对照组接受布地奈德,丙酸氟替卡松,沙美特罗-氟替卡松,或者酮替芬。这项调查包括18篇论文。所有受试者均来自中国人群。与对照组相比,联合治疗组显示出更高的有效率(相对比率[RR]=1.23,95%置信区间[CI]:1.18-1.29,p<.001),但治疗后不良反应发生率无差异(RR=0.65,95%CI:0.42-1.02,p=0.060)。此外,最大呼气流量(PEF)(SMD=1.69,95%CI:1.09-2.30,p<.001),强迫肺活量(FVC)(SMD=1.67,95%CI:0.94-2.39,p<.001),1s用力呼气量(FEV1)(SMD=1.74,95%CI:1.09-2.40,p<.001),联合治疗组治疗后FEV1/FVC(SMD=1.84,95%CI:0.41~3.28,p=0.012)明显高于对照组。与对照组相比,肿瘤坏死因子-α水平(SMD=-2.38,95%CI:-3.22至-1.55,p<.001),IL-4(SMD=-2.65,95%CI:-3.26至-2.04,p<.001),联合治疗组治疗后IgE(SMD=-2.98,95%CI:-3.24至-2.72,p<.001)显著降低。联合应用孟鲁司特钠治疗中国小儿CVA具有显著的临床效果,使其成为一种合理的治疗方法。
This meta-analysis aims to assess the clinical effectiveness of combination therapy with montelukast sodium for the treatment of cough variant asthma (CVA) in children, intending to provide clinical evidence and data to guide the selection of clinical therapy. A literature review was conducted using numerous databases, including China National Knowledge Infrastructure (CNKI), Wanfang database, Embase, PubMed, and Web of Science, from inception to December 2023. Trials meeting the criteria for the combined treatment of montelukast sodium for CVA in children were included. Stata 16.0 software was utilized for meta-analysis. The combined treatment group received montelukast sodium in addition to the control group, while the control group received budesonide, fluticasone propionate, salmeterol-fluticasone, or ketotifen alone. This investigation included 18 papers. All subjects were from the Chinese population. Compared to the control group, the combined treatment group demonstrated a higher effective rate (relative ratio [RR] = 1.23, 95% confidence interval [CI]: 1.18-1.29, p < .001), but no difference in the incidence of adverse reactions (RR = 0.65, 95% CI: 0.42-1.02, p = .060) after treatment. Moreover, the peak expiratory flow (PEF) (SMD = 1.69, 95% CI: 1.09-2.30, p < .001), forced vital capacity (FVC) (SMD = 1.67, 95% CI: 0.94-2.39, p < .001), forced expiratory volume in 1 s (FEV1) (SMD = 1.74, 95% CI: 1.09-2.40, p < .001), and FEV1/FVC (SMD = 1.84, 95% CI: 0.41-3.28, p = .012) were significantly higher in the combined treatment group than in the control group after treatment. Compared with the control group, the levels of tumor necrosis factor-α (SMD = -2.38, 95% CI: -3.22 to -1.55, p < .001), IL-4 (SMD = -2.65, 95% CI: -3.26 to -2.04, p < .001), and IgE (SMD = -2.98, 95% CI: -3.24 to -2.72, p < .001) were significantly lower in the combined treatment group after treatment. The combined use of montelukast sodium in the treatment of pediatric CVA in China is associated with a significant clinical effect, making it a reasonable therapeutic approach.