目的 系統(tǒng)評價(jià)西替利嗪口服聯(lián)用布地奈德霧化吸入治療中國患兒急性哮喘的臨床療效和安全性。方法 計(jì)算機(jī)檢索PubMed、Cochrane library、萬方數(shù)據(jù)庫、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）和維普中文期刊全文數(shù)據(jù)庫（VIP），檢索西替利嗪口服聯(lián)用布地奈德霧化（試驗(yàn)組）對比單用布地奈德霧化吸入（對照組）治療中國患兒急性哮喘隨機(jī)對照研究（RCT），檢索時(shí)限為數(shù)據(jù)庫建庫至2020年1月，對符合納入排除標(biāo)準(zhǔn)的隨機(jī)對照試驗(yàn)進(jìn)行數(shù)據(jù)提取和偏倚風(fēng)險(xiǎn)評價(jià)，然后采用RevMan 5.3軟件進(jìn)行Meta-分析。結(jié)果 共納入12項(xiàng)RCTs，1 215例患者。Meta-分析結(jié)果顯示：試驗(yàn)組總有效率（RR=1.25，95% CI=1.17～1.33）、痊愈率（RR=1.37，95% CI=1.16～1.63）均高于對照組，日間癥狀評分（SMD=-1.79，95% CI=-2.65～-0.93）和夜間癥狀評分（SMD=-1.63，95% CI=-2.42～-0.85）均小于對照組，第1秒用力呼氣量（FEV1）增加值（SMD=2.12，95% CI=1.30～2.95）、腫瘤壞死因子-α下降值（SMD=-0.74，95% CI=-0.92～-0.56）大于對照組，差異均具有統(tǒng)計(jì)學(xué)意義（P<0.01），但兩組患兒的不良反應(yīng)發(fā)生率相當(dāng)（RR=1.42，95% CI=0.89～ 2.27，P=0.14）。結(jié)論 西替利嗪口服聯(lián)用布地奈德霧化吸入治療中國患兒急性哮喘的療效確切、提高患兒肺功能、降低炎性因子優(yōu)于單用布地奈德霧化吸入，且不增加藥物不良反應(yīng)。

Objective To systematically evaluate the effectiveness and safety of cetirizine orally combined with budesonide inhalation for acute asthma in Chinese children. Methods Randomized controlled trial (RCTs) about cetirizine orally combined with budesonide inhalation (Test group) vs budesonide inhalation alone (Control group) for the treatment of acute asthma in Chinese children in databases of PubMed, Cochrane library, CNKI, CBM, VIP and Wanfang Data from inception to January 2020 were searched. Data extraction and bias risk assessment were performed on randomized controlled trials that met the inclusion exclusion criteria. Meta-analysis was performed using RevMan 5.3 software. Results Total of 12 studies involving 1 215 patients were entered. Meta analysis showed that:the total effective rate (RR=1.25, 95%CI=1.17 to 1.33) and recovery rate (RR=1.37, 95%CI=1.16 to 1.63) in the test group were greater than those in the control group, and the daytime symptom score (SMD=-1.79, 95%CI=-2.65 to -0.93) and nocturnal symptom score (SMD=-1.63, 95%CI=-2.42 to -0.85) are both lower than the control group, increased forced expiratory volume (FEV1) in the first second (SMD=2.12, 95%CI=1.30 to 2.95), and decreased value of TNF-α (SMD=-0.74, 95%CI=-0.92 to -0.56) is greater than the control group, the differences were statistically significant (P<0.01) and did not increase the incidence of ADR(RR=1.42, 95%CI=0.89 to 2.27, P=0.14). Conclusion According to the current evidence, cetirizine orally combined with budesonide inhalation is effective in treating children with acute asthma in China. It improves lung function and reduces inflammatory factors in children. And does not increase the incidence of adverse drug reactions.

R974

湖北省衛(wèi)生健康委員會聯(lián)合基金項(xiàng)目（WJ2019H465）