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山东大学学报 (医学版) ›› 2019, Vol. 57 ›› Issue (11): 27-33.doi: 10.6040/j.issn.1671-7554.0.2019.484

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克拉霉素辅助治疗哮喘疗效及安全性的Meta分析

王海霞1,李一章1,白晨晓1,姜迪1,王丽雯1,陈欧1,2   

  1. 1. 山东大学护理学院, 山东 济南 250012;2.山东大学第二医院小儿内科, 山东 济南 250033
  • 发布日期:2022-09-27
  • 通讯作者: 陈欧. E-mail:chenou@sdu.edu.cn
  • 基金资助:
    国家自然科学基金资助项目(81400072);山东省重点研发项目(2019GSF108198);山东大学人文社科青年团队项目(IFYT1811,IFYT18036)

A Meta-analysis of the efficacy and safety of clarithromycin in adjuvant treatment of asthma

WANG Haixia1, LI Yizhang1, BAI Chenxiao1, JIANG Di1, WANG Liwen1, CHEN Ou1,2   

  1. 1. Nursing School of Shandong University, Jinan 250012, Shandong, China;
    2. Departments of Pediatrics, The School Hospital of Shandong University, Jinan 250033, Shandong, China
  • Published:2022-09-27

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摘要： 目的 系统评价克拉霉素辅助治疗哮喘的疗效及安全性。 方法 检索中国知网(CNKI)、万方、重庆维普(VIP)、中国生物医学文献数据库、Pubmed、Cochrane Library、EMbase 和Web of Science数据库,检索时间均从建库至2019年3月31日,根据Cochrane风险偏倚评价工具［1］对文献质量评价。所有研究对象分为克拉霉素组和对照组(未使用克拉霉素),结局指标为肺功能指标: FEV1%(1s用力呼气容积),FEV1/FVC(用力肺活量),FEV1(L)和PEFR(呼气峰值流速)(L/min);哮喘控制问卷(ACQ)评分和ACT(哮喘控制测试)评分,应用RevMan5.5软件进行Meta分析。 结果 最终纳入11篇临床随机对照试验(RCT):英文4篇,中文7篇。Meta结果显示:(1)克拉霉素组与对照组肺功能比较FEV1% 和FEV1(L)差异无统计学意义(P>0.05),FEV1/FVC和PEFR(L/min)差异有统计学意义(P<0.05);(2)克拉霉素组与对照组ACQ评分比较差异有统计学意义(P<0.05);(3)克拉霉素组与对照组ACT评分比较差异无统计学意义(P>0.05);(4) 2篇文献报道不良反应(急性哮喘加重、胃肠道反应和呼吸道感染)。 结论 克拉霉素一定程度上可改善哮喘的肺功能［FEV1/FVC%和PEFR(L/min)］和哮喘控制情况(ACQ评分),也存在不良反应,如急性哮喘加重、胃肠道反应和呼吸道感染。

关键词: 克拉霉素, 哮喘, 随机对照试验, Meta分析

Abstract: Objective To systematically evaluate the efficacy and safety of clarithromycin in the adjuvant treatment of asthma. Methods Randomized controlled trials(RCTs)on the efficacy and safety of clarithromycin in treating asthma were searched in CNKI, Wanfang, VIP, China Biomedical Literature Database, Pubmed, Cochrane Library, EMbase and Web of Science from the establishment of databases to March 31, 2019. The quality of the literature was evaluated with Cochrane bias risk assessment tool. The subjects were divided into clarithromycin group and control group. The outcome indicators were forced expiratory volume in one second(FEV1%), forced vital capacity(FEV1/FVC), FEV1(L), peak expiratory flow rate(PEFR)(L/min), asthma control questionnaire(ACQ)score and asthma control test(ACT)score. Meta-analysis was performed using RevMan 5.5 software. Results Altogether 11 RCTs were enrolled, including 4 in English and 7 in Chinese. Meta results showed: (1) There was no significant difference in FEV1% and FEV1(L)between the clarithromycin group and control group(P>0.05), while there was significant difference in FEV1/FVC and PEFR(L/min)(P<0.05). (2) There was significant difference in ACQ score between the two groups 山 东 大 学 学 报 (医 学 版)57卷11期 -王海霞,等.克拉霉素辅助治疗哮喘疗效及安全性的Meta分析 \=-(P<0.05). (3) There was no significant difference in ACT score between the two groups(P>0.05). (4) Only 2 RCTs reported adverse reactions such as exacerbation of acute asthma, gastrointestinal reactions and respiratory infection. Conclusion Clarithromycin can improve the lung function ［FEV1/FVC% and PEFR(L/min)］ and asthma control(ACQ score). It also may cause some adverse reactions, such as exacerbation of acute asthma, gastrointestinal reactions and respiratory infection.

Key words: Clarithromycin, Asthma, Randomized controlled trials, Meta-analysis

中图分类号: 

  • R725.6
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