目的 系統(tǒng)評價麻杏石甘湯聯(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 檢索中國學(xué)術(shù)期刊全文數(shù)據(jù)庫（CNKI）、萬方數(shù)據(jù)庫、維普中文期刊全文數(shù)據(jù)庫（VIP）、中國生物醫(yī)學(xué)數(shù)據(jù)庫（CBM），Cochrane Library、Embase和PubMed數(shù)據(jù)庫中麻杏石甘湯聯(lián)合阿奇霉素治療小兒支原體肺炎的隨機(jī)對照試驗（RCT），檢索時間均為建庫至2021年2月，使用Revman 5.4.1和Stata 14.0軟件評價納入文獻(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，試驗組總有效率［RR＝1.17，95% CI（1.12，1.23），P＜0.000 01］優(yōu)于對照組，且不存在發(fā)表偏倚（P=0.542）。試驗組止咳時間［SMD＝−0.78，95% CI（−0.98，−0.58）］、退熱時間［SMD＝−1.48，95% CI（−1.95，−1.01）］、肺啰音消失時間［SMD＝−0.96，95% CI（−1.23，−0.69）］、肺部胸片影像恢復(fù)時間［SMD＝−0.80，95% CI（−1.00，−0.61）］均短于對照組，差異有統(tǒng)計學(xué)意義（P＜0.000 01）。安全性評價得出試驗組發(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)委員會支撐項目（20S21901400）