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目的评价孟鲁司特(MON)联合氟替卡松/美沙特罗(SFC)或布地奈德/福莫特罗(FOR/BUD)与单独用药相比,对中、重度儿童哮喘临床疗效的优劣。方法用计算机检索万方、维普等全文数据库,搜集观察组为SFC+MON或FOR/BUD+MON,对照组为单独使用SFC或FOR/BUD,治疗中、重度儿童哮喘的随机对照试验,按Cochrane推荐的系统评价方法进行Meta分析。结果纳入文献13篇,质量评价9篇为A级,4篇为B级。Meta分析结果显示,联合疗法能有效提高临床有效率[OR=4.59,95%CI(2.55,8.26),P<0.01]、PEF%[WMD=3.97,95%CI(0.09,7.85),P<0.05]、PEF[WMD=0.62,95%CI(0.08,1.16),P<0.05]和FEV1[WMD=0.38,95%CI(0.15,0.60),P<0.05],同时降低哮喘症状评分且未增加不良反应。结论对于中、重度儿童哮喘,MON联合SFC或FOR/BUD疗法比单独使用SFC或FOR/BUD可获得更高的临床疗效。
Objective To evaluate the clinical efficacy of montelukast (MON) combined with fluticasone / methadone (SFC) or budesonide / formoterol (FOR / BUD) in the treatment of moderate and severe asthma. Methods The full-text databases such as Wanfang and VIP were searched by computer, and the observation group was SFC + MON or FOR / BUD + MON. The control group was randomized controlled trial of SFC or FOR / BUD alone to treat moderate and severe asthma. According to Cochrane Meta-analysis of recommended systematic reviews. Results included in the literature 13, the quality evaluation of 9 for the A grade, 4 for the B grade. The results of Meta analysis showed that the combination therapy could effectively improve the clinical efficiency [OR = 4.59,95% CI 2.55,8.26, P <0.01], PEF% [WMD = 3.97,95% CI 0.09,7.85, P < 0.05], PEF [WMD = 0.62,95% CI (0.08,1.16), P <0.05] and FEV1 [WMD = 0.38,95% CI (0.15,0.60), P <0.05] Increase adverse reactions. Conclusions For moderate to severe childhood asthma, MON combined with SFC or FOR / BUD therapy can achieve higher clinical efficacy than SFC or FOR / BUD alone.