阿奇霉素联合头孢类治疗AECOPD有效性及安全性的Meta分析
Efficacy and Safety of Azithromycin Combined with Cephalosporins in Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Meta-Analysis
DOI: 10.12677/ACM.2022.122166, PDF,   
作者: 梁丽菊, 张 骞, 周晓倩, 杨富蓉, 张欣月, 李江娅, 翁稚颖*：昆明医科大学药学院暨云南省天然药物药理重点实验室，云南 昆明
关键词: 阿奇霉素；头孢类药物；AECOPD；Meta分析；Azithromycin； Cephalosporins； AECOPD； Meta Analysis
摘要: 系统评价阿奇霉素联合头孢类药物(头孢克肟、头孢克洛、头孢呋辛、头孢西丁、头孢噻肟)与单用头孢类药物治疗慢性阻塞性肺疾病急性加重期的有效性及安全性。方法：计算机检索PubMed、Cochrane、Embase、中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方数据库和维普数据库(VIP)，收集阿奇霉素联合头孢类药物(试验组)对比头孢类药物(对照组)治疗慢性阻塞性肺疾病急性加重期的随机对照试验(RCT)。筛选文献、提取资料并按Cochrane系统评价员手册5.1.0推荐的偏倚风险评估工具评价文献质量后，采用RevMan 5.3软件进行Meta分析。结果：纳入21项RCTs，共计1591例患者。Meta分析结果显示：试验组在临床总有效率[RR = 1.28, 95% CI (1.22, 1.33), P < 0.00001]、治疗后肺功能FEV1/FVC (%)情况[MD = 9.45, 95% CI (7.88, 11.03, P < 0.00001]、治疗后肺功能PEF情况[MD = 11.10, 95% CI (10.00, 12.20)，P < 0.00001]显著优于对照组，不良反应发生率[RR = 0.81, 95% CI (0.54, 1.22), P = 0.81]与对照组差异无统计学意义。结论：阿奇霉素联合头孢类药物治疗慢性阻塞性肺疾病急性加重期的疗效较好，安全性与单用头孢类药物相当。
Abstract: Objective: To systematically evaluate the efficacy and safety of azithromycin combined with cephalosporins (cefixime, cefaclor, cefuroxime, cefoxitin, cefotaxime) and cephalosporins alone in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods: Retrieved from Cochrane Library, PubMed, Embase, CBM, CNKI, VIP and Wanfang database, randomized controlled trials (RCTs) about azithromycin combined with cephalosporins (experimental group) versus cephalosporins (control group) in the treatment of acute exacerbation of chronic obstructive pulmonary disease were collected. Literature screening, data extraction and quality evaluation was evaluated by using bias risk evaluation tool recommended by Cochrane System Evaluator Manual 5.1.0, and Meta-analysis was conducted by using Rev Man 5.3 software. Results: Twenty-one RCTs were included, a total of 1591 patients. The results of meta-analysis showed that: In the experimental group, the clinical total effective rate [RR = 1.28, 95% CI (1.22, 1.33), P < 0.00001], lung function FEV1/FVC (%) after treatment [MD = 9.45, 95% CI (7.88, 11.03) P < 0.00001], lung function PEF after treatment [MD = 11.10, 95% CI (10.00, 12.20) P < 0.00001] was significantly better than the control group, the incidence of adverse reactions [RR = 0.81, 95% CI (0.54, 1.22), P = 0.81] there was no significant difference between the two groups. Conclusion: The efficacy of azithromycin combined with cephalosporins in the treatment of acute exacerbation of chronic obstructive pulmonary disease is better, and the safety was comparable to cephalosporins alone.
文章引用：梁丽菊, 张骞, 周晓倩, 杨富蓉, 张欣月, 李江娅, 翁稚颖. 阿奇霉素联合头孢类治疗AECOPD有效性及安全性的Meta分析[J]. 临床医学进展, 2022, 12(2): 1142-1152. https://doi.org/10.12677/ACM.2022.122166

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