2023 年第 4 期 第 18 卷

氨溴索联合阿奇霉素治疗小儿肺炎的Meta分析及药物经济学评价

Meta analysis and pharmacoeconomic evaluation of ambroxol combined with azithromycin in the treatment of pediatric pneumonia

作者：陶丽丽1朱洁2徐东升1虞大为3

英文作者：Tao Lili1 Zhu Jie2 Xu Dongsheng1 Yu Dawei3

单位：1中国人民解放军联勤保障部队第九〇四医院药剂科，无锡214044；2中国人民解放军联勤保障部队第九〇四医院神经外科，无锡214044；3中国人民解放军联勤保障部队第九〇四医院急诊医学科，无锡214044

英文单位：1Department of Pharmacy the 904th Hospital of Joint Logistics Support Force of Chinese People′s Liberation Army Wuxi 214044 China; 2Department of Neurosurgery the 904th Hospital of Joint Logistics Support Force of Chinese People′s Liberation Army Wuxi 214044 China; 3Department of Emergency Medicine the 904th Hospital of Joint Logistics Support Force of Chinese People′s Liberation Army Wuxi 214044 China

关键词：氨溴索；阿奇霉素；小儿肺炎；Meta分析；药物经济学

英文关键词：Ambroxol;Azithromycin;Pediatricpneumonia;Meta-analysis;Pharmacoeconomics

• 摘要：

• 目的 通过Meta分析评价盐酸氨溴索联合阿奇霉素治疗小儿肺炎的效果并进行药物经济学分析。方法 检索中国知网、中国生物医学文献数据库、万方数据库等数据库，收集建库至2022年2月盐酸氨溴索联合阿奇霉素（观察组）对比单用阿奇霉素（对照组）治疗小儿肺炎的随机对照试验，采用 Review Manager 5.3软件进行Meta分析，并在此基础上采用成本-效果分析法进行经济学评价。结果 最终纳入6篇文献，共874例患儿。Meta分析结果显示，观察组的总体疗效（比值比=3.57，95%置信区间：2.82~4.81，Z=6.59，P＜0.000 1）、退热率（比值比=3.24，95%置信区间：2.31~5.57，Z=7.26，P＜0.000 1）、咳嗽喘憋缓解率（比值比=2.34,95%置信区间：1.56~4.69，Z=7.15，P＜0.000 1）、肺部啰音消失率（比值比=2.57,95%置信区间：1.25~4.64，Z=7.27，P＜0.000 1）均优于对照组。盐酸氨溴索联合阿奇霉素的增量成本效果比为588.84元。概率敏感性分析结果显示，盐酸氨溴索联合阿奇霉素治疗的效果更好，但成本也更高。结论 与单用阿奇霉素相比，盐酸氨溴索联合阿奇霉素治疗小儿肺炎的效果更好，对于有意愿支付增加的费用者有一定的经济学优势。

• Objective To explore the effects of ambroxol hydrochloride combined with azithromycin on the treatment of pediatric pneumonia by Meta analysis, and to conduct pharmacoeconomic analysis. Methods Clinical randomized controlled trials, which about the effects on pediatric pneumonia bweteen ambroxol hydrochloride combined with azithromycin (observation group) and azithromycin alone (control group) were retrieved from China National Knowledge Infrastructure, China Biology Medicine disc, Wanfang Database and other databases, were collected from databases founded to February 2022. Review Manager 5.3 software was used to conduct Meta-analysis, and cost-effectiveness analysis was used for economic evaluation. Results Finally, 6 literatures were included, including 874 children totally. Meta-analysis showed that the total effective rate ［odds ratio (OR)=3.57, 95% confidence interval (CI): 2.82-4.81, Z=6.59, P<0.000 1］, the defervescence rate (OR=3.24, 95% CI: 2.31-5.57, Z=7.26, P<0.000 1), the cough and wheeze remission rate (OR=2.34, 95% CI: 1.56-4.69, Z=7.15, P<0.000 1), and the lung rhonchus absence rate (OR=2.57, 95% CI: 1.25-4.64, Z=7.27, P<0.000 1) in the observation group were better than those in the control group. The incremental cost-effectiveness ratio of ambroxol hydrochloride combined with azithromycin was 588.84 Yuan. Probability-sensitivity analysis showed that the effect of ambroxol hydrochloride combined with azithromycin was better, while the cost was also higher. Conclusion Compared to azithromycin alone, ambroxol hydrochloride combined with azithromycin has better effect on the treatment of pediatric pneumonia, with a certain economic advantage for those who are willing to pay increased expenses.