丙酸倍氯米松对比布地奈德雾化吸入治疗儿童哮喘急性发作的Meta-分析  

Meta-analysis of beclometasone propionate vs budesonide inhalation in treatment of acute asthma in children

作　　者：赵丹 李艳艳 程红斌[2] 汪丽丽 胡东懿 ZHAO Dan;LI Yanyan;CHENG Hongbin;WANG Lili;HU Dongyi(Department of Pediatrics,Huangshi Central Hospital of Edong Medical Group,Huangshi 435000,China;Department of Pediatrics,Huangshi Maternal and Child Health Hospital of Edong Medical Group,Huangshi 435000,China)

机构地区：[1]鄂东医疗集团黄石市中心医院儿科,湖北黄石435000 [2]鄂东医疗集团黄石市妇幼保健院儿科,湖北黄石435000

出　　处：《药物评价研究》2020年第10期2104-2111,共8页Drug Evaluation Research

基　　金：黄石市医药卫生科研项目(2016-11)。

摘　　要：目的系统评价丙酸倍氯米松对比布地奈德雾化吸入治疗儿童哮喘急性发作的临床疗效和安全性。方法计算机检索PubMed、EMbase、The Cochrane Library、中国学术期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)和维普中文期刊全文数据库(VIP)和万方数据库,检索时限均为2000年1月—2019年12月,搜集丙酸倍氯米松联用特布他林(试验组)对比布地奈德联用特布他林(对照组)雾化吸入治疗儿童哮喘急性发作的随机对照研究,对符合纳入标准的临床研究进行资料提取和质量评价,采用RevMan 5.3软件对纳入文献进行质量评价和Meta-分析。结果共纳入11篇文献(3篇英文文献和8篇中文文献),1 227例患儿。Meta-分析结果显示:试验组临床有效率[RR=0.98,95%CI=0.92~1.04]、哮喘缓解率[RR=0.97,95%CI=0.92~1.01]、临床症状评分[SMD=0.09,95%CI=-0.06~0.24]、咳嗽消失时间[SMD=0.02,95%CI=-0.32~0.36]、呼吸困难改善时间[SMD=-0.03,95%CI=-0.29~0.24]和肺部哮鸣音消失时间[SMD=0.15,95%CI=-0.11~0.41]、住院时间[SMD=0.04,95%CI=-0.09~0.17]、呼气流量峰值[SMD=-0.32,95%CI=-0.85~0.20]和不良反应发生率[RR=1.41,95%CI=0.74~2.69]与对照组比较均无显著性差异(P>0.05)。结论现有证据显示,丙酸倍氯米松雾化吸入治疗儿童哮喘急性发作的临床疗效和安全性与布地奈德相当,值得临床推广。Objective To systematically evaluate the therapeutic effect and safety of beclomethasone propionate vs budesonide inhalation in the treatment of acute asthma in children.Methods The databases of PubMed, EMbase, The Cochrane Library,CNKI,VIP, CBM and Wanfang Data were searched for randomized controlled trials(RCTs) of beclometasone propionate combination with terbutaline(the test group) vs budesonide combination with terbutaline(the control group) in the treatment of acute asthma in children from Jan.of 2000 to Dec.of 2019.Data extraction and quality assessment were performed for RCTs which met the inclusion criteria, and RevMan 5.3 software was used to perform quality assessment of the articles included and Meta-analysis.Results A total of 11 RCTs(which of 3 English and 8 Chinese) involving and 1 227 patients were included.Meta-analysis showed that clinical effectiveness [RR = 0.98, 95%CI = 0.92 to 1.04], asthma remission rate [RR = 0.97, 95%CI = 0.92 to 1.01], clinical symptom score [SMD = 0.09, 95%CI =-0.06 to 0.24 ], cough disappearance time [SMD = 0.02, 95%CI =-0.32 to 0.36], dyspnea improvement time [SMD =-0.03, 95%CI =-0.29 to 0.24], and lung wheezing disappearance time [SMD = 0.15, 95%CI =-0.11 to0.41], length of stay [SMD = 0.04, 95%CI=-0.09 to 0.17], peak expiratory flow rate [SMD =-0.32, 95%CI =-0.85 to 0.20 ] and the incidence of adverse reactions [RR = 1.41, 95%CI = 0.74 to 2.69] of test group all had no significant difference compared with the control group(P>0.05).Conclusion The existing evidence shows that the clinical efficacy and safety of nebulized beclometasone propionate in the treatment of acute asthma in children are comparable to budesonide, which is worthy of clinical promotion.

关 键 词：丙酸倍氯米松 布地奈德 特布他林 哮喘急性发作 META-分析 

分 类 号：R985[医药卫生—药品] R969.4[医药卫生—药学]