维生素A辅助治疗儿童肺炎的Meta分析

Effect of vitamin A as an adjuvant therapy for pneumonia in children: a Meta analysis

摘要:

目的 系统评价维生素A补充对儿童肺炎的疗效和安全性。方法 检索Cochrane Library、EMbase、PubMed、中国生物医学文献数据库、中国知网和万方数据库等中英文数据库，选择其中关于维生素A辅助治疗儿童肺炎的随机对照试验。由2位评价者独立阅读文献，按纳入及排除标准提取效应量并评价研究质量，采用Revman5.3软件进行Meta分析。结果 最终纳入15个临床随机对照试验，包括3 021例患者。Meta分析结果显示，加用维生素A不能降低肺炎患儿病死率（P > 0.05），但可提高其临床总有效率（P < 0.05），可缩短患儿发热、咳嗽持续时间、体征及胸片转阴时间、住院时间（P < 0.05），且未增加不良反应如恶心、呕吐、腹泻、过敏、前囟膨隆等的发生。结论 现有证据表明，辅以维生素A治疗儿童肺炎有助于缓解其临床症状体征，缩短住院时间，且不会增加不良反应的发生。

Abstract:

Objective To investigate the effect and safety of vitamin A supplementation in children with pneumonia through a systematic review.Methods Cochrane Library, EMbase, PubMed, China Biology Medicine disc, CNKI, and Wanfang Data were searched for randomized controlled trials (RCTs) on vitamin A as an adjuvant therapy for pneumonia in children. Two reviewers independently screened the studies and evaluated their quality according to the inclusion and exclusion criteria. RevMan5.3 was used for the Meta analysis.Results A total of 15 RCTs with 3 021 patients were included. The Meta analysis showed that vitamin A supplementation did not reduce the mortality of children with pneumonia (P > 0.05), but it increased the overall clinical response rate (P < 0.05) and shortened the duration of pyrexia and cough, clearance time of signs and abnormal chest X-ray results, and length of hospital stay (P < 0.05). As an adjuvant therapy, vitamin A did not increase the incidence rates of adverse reactions such as nausea, vomiting, diarrhea, allergy, and bregma bulging.Conclusions Current evidence shows that in the treatment of pneumonia in children, vitamin A supplementation helps to relieve clinical symptoms and signs and shorten the length of hospital stay.The adjuvant therapy does not increase the incidence rates of adverse reactions.