摘要
目的系统评价特布他林联合布地奈德雾化吸入治疗小儿哮喘急性发作的临床疗效和安全性,为临床用药提供循证医学依据。方法通过检索中国知网、中国生物医学文献服务系统、万方医学数据库、维普、PubMed、Cochrane Library、Web of Science、EM-base数据库,检索时间均从建库至2022年12月1日,收集特布他林联合布地奈德雾化吸入治疗小儿哮喘急性发作的随机对照试验(RCT)文献,由2名研究员各自独立严格进行纳入研究的质量评价和资料提取,应用RevMan5.3软件进行meta分析,TSA0.9软件进行试验序贯分析。结果共纳入59篇RCT,5179例患者,其中试验组2610例,对照组2569例。meta分析结果显示:试验组患者临床总有效率[比值比(OR)=5.70,95%CI(4.64,7.00),Z=16.64,P<0.00001]、呼吸困难消失时间[标准化均方差(SMD)=-1.44,95%CI(-1.83,-1.06),Z=7.42,P<0.00001]、咳嗽消失时间[SMD=-1.68,95%CI(-2.03,-1.34),Z=9.67,P<0.00001]、用力肺活量(FVC)[SMD=1.02,95%CI(0.69,1.36),Z=5.93,P<0.00001]、第1秒用力呼气量(FEV_(1))[SMD=0.97,95%CI(0.71,1.23),Z=7.22,P<0.00001]、不良反应[OR=0.44,95%CI(0.30,0.65),P<0.001],且试验序贯分析进一步肯定了临床疗效和不良反应的meta分析结果。结论特布他林联合布地奈德雾化吸入治疗小儿哮喘急性发作,可显著提高临床疗效,减轻患者临床症状,改善肺功能,减少不良反应。
Objective To systematically evaluate the clinical efficacy and safety of terbutaline combined with budesonide aerosol inhalation in the treatment of acute attack of asthma in children,and to provide evidence-based medical basis for clinical medication.Methods By searching China National Knowledge Infrastructure,China Biology Medicine,Wanfang,VIP,PubMed,Cochrane Library,Web of Science and EM-Base databases,the retrieval time was from the database construction to December 1,2022.The literatures of randomized controlled trials(RCT)of terbutaline combined with budesonide aerosol inhalation in the treatment of acute attack of asthma in children were collected.The quality evaluation and data extraction of the included research were strictly carried out by two researchers independently.RevMan5.3 software was used for meta-analysis and TSA0.9 software was used for trial sequential analysis.Results A total of 59 RCT articles were included,including 5179 patients,which 2610 patients were in the experimental group and 2569 patients were in the control group.Meta-analysis results showed that thetotal clinical effective rate[odds ratio(OR)=5.70,95%CI(4.64,7.00),Z=16.64,P<0.00001],time to disappearance of dyspnea[standardized mean difference(SMD)=-1.44,95%CI(-1.83,-1.06),Z=7.42,P<0.00001],cough disappearance time[SMD=-1.68,95%CI(-2.03,-1.34),Z=9.67,P<0.00001],forced vital capacity(FVC)[SMD=1.02,95%CI(0.69,1.36),Z=5.93,P<0.00001],forced expiratory volume in the first second(FEV_(1))[SMD=0.97,95%CI(0.71,1.23),Z=7.22,P<0.00001],adverse reactions[OR=0.44,95%CI(0.30,0.65),P<0.001],and the trial sequential analysis further confirmed the results of meta-analysis of clinical efficacy and adverse reactions.Conclusion Terbutaline combined with budesonide aerosol inhalation in the treatment of acute attack of asthma in children can significantly improve the clinical efficacy,relieve the clinical symptoms,improve lung function and reduce adverse reactions in children with acute asthma.
作者
田洪星
钟升兵
李悦
郑晓霞
TIAN Hongxing;ZHONG Shengbing;LI Yue;ZHENG Xiaoxia(Guiyang Maternal and Child Health Care Hospital/Guiyang Children′s Hospital,Guiyang,Guizhou 550003,China;Zunyi Maternal and Child Health Hospital,Zunyi,Guizhou 563099,China)
出处
《现代医药卫生》
2023年第22期3862-3871,3878,共11页
Journal of Modern Medicine & Health
