吕晓龙　蔺静静

1.信阳职业技术学院医学院，河南信阳464000；2.信阳职业技术学院附属医院呼吸内科，河南信阳464000

罗红霉素辅助治疗支气管哮喘有效性的Meta分析

吕晓龙1蔺静静2

1.信阳职业技术学院医学院，河南信阳464000；2.信阳职业技术学院附属医院呼吸内科，河南信阳464000

目的系统评价罗红霉素辅助治疗支气管哮喘的有效性。方法计算机检索PubMed、Cochrane图书馆、中国期刊全文数据库、万方数据库、中文科技期刊数据库，检索时限为1987～2015年。收集以支气管哮喘的治疗方法为分组依据的随机对照试验，对照组给予舒张支气管、缓解气道炎症等常规药物，试验组在对照组基础上加用罗红霉素。研究指标为支气管哮喘的治疗总有效率和肺功能改善情况，提取符合纳入标准的研究资料进行Meta分析。结果共纳入12项试验942例患者进行Meta分析，结果显示，试验组患者支气管哮喘治疗总有效率（RR=1.20，95%CI 1.13～1.28，P<0.000 01）、FEV1水平（MD=0.18，95%CI 0.07～0.28，P=0.0008）、FEV1%水平（MD= 5.25，95%CI 3.93～6.58，P<0.000 01）、PEF水平（MD=0.44，95%CI 0.29～0.58，P＜0.000 01）均明显高于对照组，差异有高度统计学意义。结论罗红霉素辅助治疗支气管哮喘能够改善肺功能，具有明显的疗效。

罗红霉素；支气管哮喘；有效性；Meta分析

［Abstract］Objective To systematically review the efficacy of Roxithromycin in the adjuvant therapy of bronchial asthma.Methods Retrieved from PubMed，Cochrane Library，CJFD，Wanfang Database and VIP between 1987 and 2015，randomized controlled trials（RCT）about grouping by treatment of bronchial asthma were collected.The control group received relaxation of bronchial，relieve airway inflammation and other conventional drugs.Experimental group was given Roxithromycin on the basis of the control group.Indexes of the total effective rate of treatment and pulmonary function were observed.Studies of conforming inclusion criteria were extracted by Meta-analysis.Results This Meta-analysis involved 12 trials and 942 patients in total.Results of Meta-analysis showed the total effective rate of treatment（RR=1.20 95%CI 1.13-1.28，P<0.000 01），FEV1levels（MD=0.18，95%CI 0.07-0.28，P=0.0008），FEV1% levels（MD=5.25，95%CI 3.93-6.58，P<0.000 01）and PEF levels（MD=0.44，95%CI 0.29-0.58，P＜0.000 01）in the experimental group were significantly higher than those of the control group，with statistically significant differences. Conclusion Roxithromycin can improve lung function in adjuvant treatment of bronchial asthma，it has a significant effect.

［Key words］Roxithromycin；Bronchial asthma；Effectiveness；Meta-analysis

支气管哮喘［1-3］是以发作性喘息、气促、胸闷和咳嗽为主要临床症状的常见疾病，其发病实质是多种细胞和细胞组分参与的气道慢性炎性反应，主要的治疗方法是舒张支气管和控制气道炎症，而持续规律的抗炎治疗是支气管治疗的关键。罗红霉素作为大环内酯类药物的代表，除存在广谱的抗菌作用外，还具有稳定细胞膜，延缓机体内白细胞的聚集、黏附、渗出，削弱粒细胞的趋化作用，抑制多种炎症介质和细胞因子的释放，加速中性粒细胞凋亡等较强的抗炎活性［4］。……