目的 系統(tǒng)評(píng)價(jià)麻杏石甘湯聯(lián)合阿奇霉素治療小兒支原體肺炎（MPP）的療效及安全性。方法 檢索中國(guó)學(xué)術(shù)期刊全文數(shù)據(jù)庫(kù)（CNKI）、萬方數(shù)據(jù)庫(kù)、維普中文期刊全文數(shù)據(jù)庫(kù)（VIP）、中國(guó)生物醫(yī)學(xué)數(shù)據(jù)庫(kù)（CBM），Cochrane Library、Embase和PubMed數(shù)據(jù)庫(kù)中麻杏石甘湯聯(lián)合阿奇霉素治療小兒支原體肺炎的隨機(jī)對(duì)照試驗(yàn)（RCT），檢索時(shí)間均為建庫(kù)至2021年2月，使用Revman 5.4.1和Stata 14.0軟件評(píng)價(jià)納入文獻(xiàn)質(zhì)量并進(jìn)行Meta分析。結(jié)果 共納入13篇RCTs，包括1 240例患者，試驗(yàn)組總有效率［RR＝1.17，95% CI（1.12，1.23），P＜0.000 01］優(yōu)于對(duì)照組，且不存在發(fā)表偏倚（P=0.542）。試驗(yàn)組止咳時(shí)間［SMD＝−0.78，95% CI（−0.98，−0.58）］、退熱時(shí)間［SMD＝−1.48，95% CI（−1.95，−1.01）］、肺啰音消失時(shí)間［SMD＝−0.96，95% CI（−1.23，−0.69）］、肺部胸片影像恢復(fù)時(shí)間［SMD＝−0.80，95% CI（−1.00，−0.61）］均短于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P＜0.000 01）。安全性評(píng)價(jià)得出試驗(yàn)組發(fā)生不良反應(yīng)的次數(shù)［RR＝0.39，95% CI（0.24，0.64），P=0.0002］少于對(duì)照組。結(jié)論 麻杏石甘湯聯(lián)合阿奇霉素治療小兒MPP較單用阿奇霉素療效顯著，安全性高，有良好的臨床應(yīng)用價(jià)值，由于存在一定局限性，上述結(jié)論需更多高質(zhì)量的研究來進(jìn)行驗(yàn)證。

Objective To systematically evaluate the efficacy and safety of combining Maxing Shigan Decoction with azithromycin in the treatment of Mycoplasma pneumonia pneumonia (MPP) in children. Methods Randomised controlled trials (RCT) of Maxing Shigan Decoction combined with azithromycin in the treatment of MPP in paediatric patients were searched in the Chinese National Knowledge Infrastructure (CNKI), Wanfang Database, China Science and Technology Journal Database (VIP), China Biomedical Literature Database (CBM), Cochrane Library, Embase and PubMed, all from built to February 2021. Revman 5.4.1 and Stata 14.0 was used to evaluate the quality of included literatures and Meta-analysis. Results A total of 13 RCT s involving 1 240 patients were included. According to the results, the effective rate of the trial group [RR = 1.17, 95%CI (1.12, 1.23), P < 0.000 01] was better than that of the control group. The funnel chart and Begg's test indicated that there was no publication bias (P = 0.542). The cough disappearance time [SMD = −0.78, 95%CI (−0.98, −0.58)], body temperature recovery time [SMD = −1.48, 95%CI (−1.95, −1.01)], disappearance time of pulmonary rales [SMD = −0.96, 95%CI (−1.23, −0.69)] and lung X-ray recovery time [SMD = −0.80, 95%CI (−1.00, −0.61)] of the trial group were all significantly lower than the control group (P < 0.000 01). Safety evaluation showed that the frequency of adverse reactions in the test group [RR = 0.39, 95%CI (0.24, 0.64), P = 0.000 2] was less than the control group. Conclusion The combination of Maxing Shigan Decoction and azithromycin is more effective and safer than azithromycin alone in the treatment of children with MPP, and has good clinical application value. Due to some limitations, more high-quality studies are needed for further verification.

R985;R287.5

上海市科學(xué)技術(shù)委員會(huì)支撐項(xiàng)目（20S21901400）