目的 系統(tǒng)的評(píng)價(jià)應(yīng)用含胸腺肽方案治療耐多藥肺結(jié)核（MDR-TB）的有效性及安全性，為優(yōu)化治療方案提供參考依據(jù)。方法 通過檢索Pubmed、Embase、Cochrane Library、中國學(xué)術(shù)期刊全文數(shù)據(jù)庫（CNKI）、中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫（CBM）、維普中文期刊全文數(shù)據(jù)庫（VIP）和萬方數(shù)據(jù)庫自建庫至2019年5月公開發(fā)表的含胸腺肽方案治療MDR-TB的臨床隨機(jī)對(duì)照試驗(yàn)（RCTs），并根據(jù)Cochrane 5.1.0評(píng)價(jià)手冊(cè)納入文獻(xiàn)進(jìn)行質(zhì)量評(píng)價(jià)，并使用Review Manager 5.3軟件進(jìn)行Meta-分析。結(jié)果 共納入15個(gè)RCTs，計(jì)1 457名患者。Meta-分析結(jié)果顯示：與對(duì)照組相比實(shí)驗(yàn)組痰菌陰轉(zhuǎn)率[OR=3.24，95%CI（2.49~4.22），P<0.000 01]、病灶吸收率[OR=3.79，95%CI（2.03~7.05），P<0.000 1]和空洞閉合率[OR=2.73，95%CI（2.01~3.71），P<0.0000 1]均明顯升高；而在肝功能受損率[OR=0.85，95%CI（0.55~1.34），P=0.49]、胃腸道反應(yīng)率[OR=1.03，95%CI（0.62~1.72），P=0.90]和皮疹發(fā)生率[OR=0.77，95%CI（0.26~2.26），P=0.64]方面差異無統(tǒng)計(jì)學(xué)意義。結(jié)論 應(yīng)用含胸腺肽聯(lián)合抗結(jié)核藥物方案可提高的MDR-TB治愈率，且總體安全性較好。

Objective To systematically evaluate the efficacy and safety of thymosin-containing regimens for the treatment of multidrug resistant tuberculosis (MDR-TB), providing more reference for future treatment of MDR-TB. Methods RCTs of thymosincontaining regimens for the treatment of MDR-TB were published by searching Pubmed, Embase, Cochrane Library CNKI, CBM, VIP and Wanfang database before May 2019 and based on the Cochrane 5.1.0 evaluation manual, the quality evaluation and metaanalysis of included literatures were performed using Review Manager 5.3 software. Results A total of 1 457 patients were enrolled in this study,consisting of 15 RCTs. Meta-analysis showed that the sputum negative conversion rate[OR=3.24, 95%CI(2.49-4.22), P<0.000 01], the lesion absorption rate[OR=3.79, 95%CI(2.03-7.05), P<0.000 1], and the cavity closure rate[OR=2.73, 95%CI (2.01-3.71), P<0.00001] were significantly higher in the experimental group than the control group. There were no significant difference in the liver damage rate[OR=0.85, 95%CI(0.55-1.34), P=0.49], the gastrointestinal reaction rate[OR=1.03, 95%CI (0.62-1.72), P=0.90], and the rash incidence rate[OR=0.77, 95%CI(0.26-2.26), P=0.64]. Conclusion The application of thymosin combined with anti-tuberculosis drugs can improve the cure rate of MDR-TB,and the overall safety is great.