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目的探讨左氧氟沙星序贯疗法与常规静脉注射治疗社区获得性肺炎(CAP)的临床疗效和安全性,为左氧氟沙星序贯疗法治疗CAP提供循证学依据。方法在万方数据库(WANFANGDATA)和中国知网数据库(CNKI)查找左氧氟沙星序贯治疗CAP的随机对照研究,对纳入研究采用Meta分析方法,比较痊愈率、总有效率和不良反应发生率;发表性偏倚检验采用Begg’s检验和Egger’s检验。结果最终共有9篇纳入研究,合计784例,研究组401例,对照组383例。文献Jadad质量评价为1~3分。结果显示2组的总有效率(Z=0.49,P=0.626,OR=0.873,95%CI 0.506~1.507)和痊愈率(Z=0.92,P=0.356,OR=1.168,95%CI 0.840~1.622)比较差异无统计学意义,2组的不良反应发生率比较差异有统计学意义(Z=4.23,P=0.000,OR=0.349,95%CI0.214~0.568)。Begg’s检验显示Pr>|Z|=0.230>0.05,Egger’s检验显示P>|t|=0.221>0.05,无发表性偏倚。结论左氧氟沙星序贯疗法治疗CAP,与常规静脉滴注疗效相当,但却能明显降低不良反应发生率。
Objective To investigate the clinical efficacy and safety of sequential levofloxacin and routine intravenous injection in the treatment of community-acquired pneumonia (CAP), and to provide an evidence-based basis for the sequential treatment of CAP with levofloxacin. Methods A randomized controlled trial of levofloxacin sequential treatment of CAP in WANFANGDATA and CNKI databases was conducted. Meta-analysis was used for the included studies to compare the cure rate, total effective rate and adverse reaction rate. Bias test using Begg’s test and Egger’s test. Finally, a total of 9 results were included in the study, with a total of 784 cases, 401 cases in the study group and 383 cases in the control group. Jadad quality evaluation of the literature for the 1 to 3 points. The results showed that the total effective rate (Z = 0.49, P = 0.626, OR = 0.873, 95% CI 0.506-1.507) and the cure rate (Z = 0.92, P = 0.356, OR = 1.168, 95% CI 0.840-1.622 There was no significant difference between the two groups (Z = 4.23, P = 0.000, OR = 0.349, 95% CI0.214-0.568). Begg’s test showed Pr> | Z | = 0.230> 0.05, Egger’s test showed P> | t | = 0.221> 0.05, no published bias. Conclusion Sequential levofloxacin treatment of CAP, with the same effect as conventional intravenous drip, but can significantly reduce the incidence of adverse reactions.