Wuhu decoction combined with azithromycin for treatment of Mycoplasma pneumoniae pneumonia in Asian children: a systematic review and meta analysis of randomized controlled trials
Objective: This study constitutes a pioneering systematic review and meta analysis delving into the clinical efficacy and safety of the combined therapy involving Wuhu Decoction and azithromycin for treating Mycoplasma pneumoniae pneumonia in pediatric patients.Methods: This study conducted a compre...
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| Format: | Article |
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Frontiers Media S.A.
2024-04-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2024.1329516/full |
| _version_ | 1797226591449776128 |
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| author | Shuo Yang Shuo Yang Xinying Liu Xinying Liu Huizhe Wang Huizhe Wang Haokai Wang Haokai Wang Dan Sun Dan Sun Yaowei Han Yaowei Han Huanmin Li Huanmin Li Xinmin Li Xinmin Li |
| author_facet | Shuo Yang Shuo Yang Xinying Liu Xinying Liu Huizhe Wang Huizhe Wang Haokai Wang Haokai Wang Dan Sun Dan Sun Yaowei Han Yaowei Han Huanmin Li Huanmin Li Xinmin Li Xinmin Li |
| author_sort | Shuo Yang |
| collection | DOAJ |
| description | Objective: This study constitutes a pioneering systematic review and meta analysis delving into the clinical efficacy and safety of the combined therapy involving Wuhu Decoction and azithromycin for treating Mycoplasma pneumoniae pneumonia in pediatric patients.Methods: This study conducted a comprehensive computerized search, covering 6 Chinese databases and 6 English databases, to collect randomized controlled trials related to the combined use of Wuhu Decoction and azithromycin for treating Mycoplasma pneumoniae pneumonia in pediatric patients. The search was extended until August 2023. Two independent researchers were involved in literature screening, data extraction, and bias risk assessment. Meta-analysis was performed using Stata 14.0 and RevMan 5.4 software. Additionally, meta-regression analysis and subgroup analysis were carried out on primary outcomes to identify potential sources of heterogeneity and confounding factors.Results: A total of 22 randomized controlled trials involving 2,026 patients were included in this study. The combined therapy of Wuhu Decoction and azithromycin demonstrated superior efficacy compared to azithromycin alone (RR = 1.17, 95% CI [1.13, 1.21], p < 0.00001; low certainty of evidence). Additionally, patients receiving the combination therapy experienced significantly reduced the disappearance time of fever (MD = −1.42, 95% CI [−1.84, −1.00], p < 0.00001; very low certainty of evidence), disappearance time of cough (MD = −2.08, 95% CI [−2.44, −1.71], p < 0.00001; very low certainty of evidence), disappearance of pulmonary rales (MD = −1.97, 95% CI [−2.31, −1.63], p < 0.00001; very low certainty of evidence), and disappearance time of wheezing (MD = −1.47, 95% CI [−1.72, −1.22], p < 0.00001; very low certainty of evidence). Meta-regression analysis suggested that course of disease, sample size, and age might be sources of heterogeneity. Subgroup and sensitivity analyses reaffirmed the stability of these results. Furthermore, analyses of secondary outcomes such as T lymphocytes, serum inflammatory factors, and the incidence rate of adverse reactions consistently favored the combination therapy of WHD and azithromycin over azithromycin alone, with statistically significant differences.Conclusion: Based on our meta-analysis findings, the combined therapy of Wuhu Decoction and azithromycin for treating pediatric Mycoplasma pneumoniae pneumonia exhibited superior overall efficacy in comparison to azithromycin monotherapy. However, in the included 22 studies, the majority of evaluated factors showed unclear bias risks, and a persistent bias risk was consistently present within one category. Moreover, due to the low quality of evidence, interpreting these results should be approached with caution. Hence, we emphasize the necessity for future high-quality, multicenter, and large-sample clinical randomized controlled trials. These trials are essential to provide more robust data for evidence-based research and to establish higher-quality evidence support.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/, identifier CRD42023465606 |
| first_indexed | 2024-04-24T14:27:21Z |
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| language | English |
| last_indexed | 2024-04-24T14:27:21Z |
| publishDate | 2024-04-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Pharmacology |
| spelling | doaj.art-de82583da2a04be8ad697e3cbb32d5d12024-04-03T04:41:02ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122024-04-011510.3389/fphar.2024.13295161329516Wuhu decoction combined with azithromycin for treatment of Mycoplasma pneumoniae pneumonia in Asian children: a systematic review and meta analysis of randomized controlled trialsShuo Yang0Shuo Yang1Xinying Liu2Xinying Liu3Huizhe Wang4Huizhe Wang5Haokai Wang6Haokai Wang7Dan Sun8Dan Sun9Yaowei Han10Yaowei Han11Huanmin Li12Huanmin Li13Xinmin Li14Xinmin Li15Department of Pediatrics, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaNational Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, ChinaDepartment of Pediatrics, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaNational Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, ChinaDepartment of Pediatrics, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaNational Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, ChinaDepartment of Pediatrics, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaNational Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, ChinaDepartment of Pediatrics, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaNational Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, ChinaDepartment of Pediatrics, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaNational Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, ChinaDepartment of Pediatrics, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaNational Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, ChinaDepartment of Pediatrics, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaNational Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, ChinaObjective: This study constitutes a pioneering systematic review and meta analysis delving into the clinical efficacy and safety of the combined therapy involving Wuhu Decoction and azithromycin for treating Mycoplasma pneumoniae pneumonia in pediatric patients.Methods: This study conducted a comprehensive computerized search, covering 6 Chinese databases and 6 English databases, to collect randomized controlled trials related to the combined use of Wuhu Decoction and azithromycin for treating Mycoplasma pneumoniae pneumonia in pediatric patients. The search was extended until August 2023. Two independent researchers were involved in literature screening, data extraction, and bias risk assessment. Meta-analysis was performed using Stata 14.0 and RevMan 5.4 software. Additionally, meta-regression analysis and subgroup analysis were carried out on primary outcomes to identify potential sources of heterogeneity and confounding factors.Results: A total of 22 randomized controlled trials involving 2,026 patients were included in this study. The combined therapy of Wuhu Decoction and azithromycin demonstrated superior efficacy compared to azithromycin alone (RR = 1.17, 95% CI [1.13, 1.21], p < 0.00001; low certainty of evidence). Additionally, patients receiving the combination therapy experienced significantly reduced the disappearance time of fever (MD = −1.42, 95% CI [−1.84, −1.00], p < 0.00001; very low certainty of evidence), disappearance time of cough (MD = −2.08, 95% CI [−2.44, −1.71], p < 0.00001; very low certainty of evidence), disappearance of pulmonary rales (MD = −1.97, 95% CI [−2.31, −1.63], p < 0.00001; very low certainty of evidence), and disappearance time of wheezing (MD = −1.47, 95% CI [−1.72, −1.22], p < 0.00001; very low certainty of evidence). Meta-regression analysis suggested that course of disease, sample size, and age might be sources of heterogeneity. Subgroup and sensitivity analyses reaffirmed the stability of these results. Furthermore, analyses of secondary outcomes such as T lymphocytes, serum inflammatory factors, and the incidence rate of adverse reactions consistently favored the combination therapy of WHD and azithromycin over azithromycin alone, with statistically significant differences.Conclusion: Based on our meta-analysis findings, the combined therapy of Wuhu Decoction and azithromycin for treating pediatric Mycoplasma pneumoniae pneumonia exhibited superior overall efficacy in comparison to azithromycin monotherapy. However, in the included 22 studies, the majority of evaluated factors showed unclear bias risks, and a persistent bias risk was consistently present within one category. Moreover, due to the low quality of evidence, interpreting these results should be approached with caution. Hence, we emphasize the necessity for future high-quality, multicenter, and large-sample clinical randomized controlled trials. These trials are essential to provide more robust data for evidence-based research and to establish higher-quality evidence support.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/, identifier CRD42023465606https://www.frontiersin.org/articles/10.3389/fphar.2024.1329516/fullWuhu decoctionMycoplasma pneumoniae pneumoniasystematic reviewmeta analysisclinical research |
| spellingShingle | Shuo Yang Shuo Yang Xinying Liu Xinying Liu Huizhe Wang Huizhe Wang Haokai Wang Haokai Wang Dan Sun Dan Sun Yaowei Han Yaowei Han Huanmin Li Huanmin Li Xinmin Li Xinmin Li Wuhu decoction combined with azithromycin for treatment of Mycoplasma pneumoniae pneumonia in Asian children: a systematic review and meta analysis of randomized controlled trials Frontiers in Pharmacology Wuhu decoction Mycoplasma pneumoniae pneumonia systematic review meta analysis clinical research |
| title | Wuhu decoction combined with azithromycin for treatment of Mycoplasma pneumoniae pneumonia in Asian children: a systematic review and meta analysis of randomized controlled trials |
| title_full | Wuhu decoction combined with azithromycin for treatment of Mycoplasma pneumoniae pneumonia in Asian children: a systematic review and meta analysis of randomized controlled trials |
| title_fullStr | Wuhu decoction combined with azithromycin for treatment of Mycoplasma pneumoniae pneumonia in Asian children: a systematic review and meta analysis of randomized controlled trials |
| title_full_unstemmed | Wuhu decoction combined with azithromycin for treatment of Mycoplasma pneumoniae pneumonia in Asian children: a systematic review and meta analysis of randomized controlled trials |
| title_short | Wuhu decoction combined with azithromycin for treatment of Mycoplasma pneumoniae pneumonia in Asian children: a systematic review and meta analysis of randomized controlled trials |
| title_sort | wuhu decoction combined with azithromycin for treatment of mycoplasma pneumoniae pneumonia in asian children a systematic review and meta analysis of randomized controlled trials |
| topic | Wuhu decoction Mycoplasma pneumoniae pneumonia systematic review meta analysis clinical research |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2024.1329516/full |
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