目的 系統(tǒng)評價丙酸倍氯米松對比布地奈德霧化吸入治療兒童哮喘急性發(fā)作的臨床療效和安全性。方法 計算機檢索PubMed、EMbase、The Cochrane Library、中國學術(shù)期刊全文數(shù)據(jù)庫（CNKI）、中國生物醫(yī)學文獻數(shù)據(jù)庫（CBM）和維普中文期刊全文數(shù)據(jù)庫（VIP）和萬方數(shù)據(jù)庫，檢索時限均為2000年1月-2019年12月，搜集丙酸倍氯米松聯(lián)用特布他林（試驗組）對比布地奈德聯(lián)用特布他林（對照組）霧化吸入治療兒童哮喘急性發(fā)作的隨機對照研究，對符合納入標準的臨床研究進行資料提取和質(zhì)量評價，采用RevMan 5.3軟件對納入文獻進行質(zhì)量評價和Meta-分析。結(jié)果 共納入11篇文獻（3篇英文文獻和8篇中文文獻），1 227例患兒。Meta-分析結(jié)果顯示：試驗組臨床有效率[RR=0.98，95%CI=0.92~1.04]、哮喘緩解率[RR=0.97，95%CI=0.92~1.01]、臨床癥狀評分[SMD=0.09，95%CI=-0.06~0.24]、咳嗽消失時間[SMD=0.02，95%CI=-0.32~0.36]、呼吸困難改善時間[SMD=-0.03，95%CI=-0.29~0.24]和肺部哮鳴音消失時間[SMD=0.15，95%CI=-0.11~0.41]、住院時間[SMD=0.04，95%CI=-0.09~0.17]、呼氣流量峰值[SMD=-0.32，95%CI=-0.85~0.20]和不良反應發(fā)生率[RR=1.41，95%CI=0.74~2.69]與對照組比較均無顯著性差異（P>0.05）。結(jié)論 現(xiàn)有證據(jù)顯示，丙酸倍氯米松霧化吸入治療兒童哮喘急性發(fā)作的臨床療效和安全性與布地奈德相當，值得臨床推廣。

Objective To systematically evaluate the therapeutic effect and safety of beclomethasone propionate vs budesonide inhalation in the treatment of acute asthma in children. Methods The databases of PubMed, EMbase, The Cochrane Library,CNKI, VIP, CBM and Wanfang Data were searched for randomized controlled trials (RCTs) of beclometasone propionate combination with terbutaline (the test group) vs budesonide combination with terbutaline (the control group) in the treatment of acute asthma in children from Jan. of 2000 to Dec. of 2019. Data extraction and quality assessment were performed for RCTs which met the inclusion criteria, and RevMan 5.3 software was used to perform quality assessment of the articles included and Meta-analysis. Results A total of 11 RCTs (which of 3 English and 8 Chinese) involving and 1 227 patients were included. Meta-analysis showed that clinical effectiveness[RR=0.98, 95%CI=0.92 to 1.04], asthma remission rate[RR=0.97, 95%CI=0.92 to 1.01], clinical symptom score[SMD=0.09, 95%CI=-0.06 to 0.24], cough disappearance time[SMD=0.02, 95%CI=-0.32 to 0.36], dyspnea improvement time[SMD=-0.03, 95%CI=-0.29 to 0.24], and lung wheezing disappearance time[SMD=0.15, 95%CI=-0.11 to 0.41], length of stay[SMD=0.04, 95%CI=-0.09 to 0.17], peak expiratory flow rate[SMD=-0.32, 95%CI=-0.85 to 0.20] and the incidence of adverse reactions[RR=1.41, 95%CI=0.74 to 2.69] of test group all had no significant difference compared with the control group (P>0.05). Conclusion The existing evidence shows that the clinical efficacy and safety of nebulized beclometasone propionate in the treatment of acute asthma in children are comparable to budesonide, which is worthy of clinical promotion.

R985;R969.4

黃石市醫(yī)藥衛(wèi)生科研項目（2016-11）