Mycobacterium vaccae as Adjuvant Therapy to Anti-Tuberculosis Chemotherapy in Never-Treated Tuberculosis Patients A Meta-Analysis 英文参考文献.docVIP

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Mycobacterium vaccae as Adjuvant Therapy to Anti-Tuberculosis Chemotherapy in Never-Treated Tuberculosis Patients A Meta-Analysis 英文参考文献.doc

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Mycobacterium vaccae as Adjuvant Therapy to Anti-Tuberculosis Chemotherapy in Never-Treated Tuberculosis Patients A Meta-Analysis 英文参考文献

MycobacteriumvaccaeasAdjuvantTherapytoAnti- TuberculosisChemotherapyinNever-Treated TuberculosisPatients:AMeta-Analysis Xiao-YanYang1.,Qun-FeiChen1.,You-PingLi1*,Si-MiaoWu2 1ChineseEvidence-BasedMedicineCenter/TheChineseCochraneCenter,WestChinaHospital,SichuanUniversity,Chengdu,China,2WestChinaMedicalSchool,Sichuan University,Chengdu,China Abstract Objective: To evaluate the effectiveness and safety of heat-killed M.vaccae added to chemotherapy of never-treated tuberculosis(TB)patients. Methods:ThedatabasesofMedline,Embase,Biosis,CochraneCentralRegisterofControlledTrials,SCI,CBM,VIPandCNKI weresearched.Randomizedcontrolledtrials(RCT)andControlledclinicaltrials(CCT)comparingM.vaccaewithorwithouta placebo-control injection as adjuvant therapy in the chemotherapy of never-treated TB patients were included. Two reviewersindependentlyperformeddataextractionandqualityassessment.DatawereanalyzedusingRevMan5.0software byTheCochraneCollaboration. Results:Fiftyfourstudieswereincluded.Attheendofthefollow-upperiod,PooledRR(RiskRatio)andits95%CIofsputum smear conversion rate were 1.07 (1.04, 1.10) in TB patients without complications, 1.17 (0.92, 1.49) in TB patients with diabetesmellitus,1.02(0.94,1.10)inTBpatientswithhepatitisB,and1.46(0.21,10.06)inTBpatientswithpneumosilicosis. In elderly TB patients the RRwas 1.22(1.13, 1.32). Analysis of eachtime point during thefollow-up period showed that M.vaccaecouldhelptoimprovetheremovalofacid-fastbacillifromthesputum,andpromoteimprovementofradiological focallesionsandcavityclosure.Comparedwiththecontrolgroup,thedifferencesinlevelsofimmunologicalindicatorsof Th1 such as IL-2 and TNF-a were not statistical significant (P=0.65 and 0.31 respectively), and neither was that of IL-6 producedbyTh2(P=0.52).AneffectofM.vaccaeofpreventionofliverdamagewasfoundinTBpatientswithhepatitisB (RR0.20and95%CI(0.12,0.33).Nosystemicadverseeventswerereported. Conclusion: Added to chemotherapy, M.vaccae is helpful in the treatment of never-treated TB pati