Network Meta-Analysis of Three Different Interventional Methods for the Treatment of Tracheobronchial Tuberculosis

Xiaodie YAO; Hao FAN; Lingjun SHEN; Shengan ZHENG; Menghan JIANG; Lei SHEN; Jie CHEN; Xing LIU

doi:10.12259/j.issn.2095-610X.S20230912

Volume 44 Issue 9

Sep. 2023

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Article Navigation > Journal of Kunming Medical University > 2023 > 44(9): 110-120

Xiaodie YAO, Hao FAN, Lingjun SHEN, Shengan ZHENG, Menghan JIANG, Lei SHEN, Jie CHEN, Xing LIU. Network Meta-Analysis of Three Different Interventional Methods for the Treatment of Tracheobronchial Tuberculosis[J]. Journal of Kunming Medical University, 2023, 44(9): 110-120. doi: 10.12259/j.issn.2095-610X.S20230912

Citation:

Xiaodie YAO, Hao FAN, Lingjun SHEN, Shengan ZHENG, Menghan JIANG, Lei SHEN, Jie CHEN, Xing LIU. Network Meta-Analysis of Three Different Interventional Methods for the Treatment of Tracheobronchial Tuberculosis[J]. Journal of Kunming Medical University, 2023, 44(9): 110-120. doi: 10.12259/j.issn.2095-610X.S20230912

Citation:

Xiaodie YAO, Hao FAN, Lingjun SHEN, Shengan ZHENG, Menghan JIANG, Lei SHEN, Jie CHEN, Xing LIU. Network Meta-Analysis of Three Different Interventional Methods for the Treatment of Tracheobronchial Tuberculosis[J]. Journal of Kunming Medical University, 2023, 44(9): 110-120. doi: 10.12259/j.issn.2095-610X.S20230912

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Network Meta-Analysis of Three Different Interventional Methods for the Treatment of Tracheobronchial Tuberculosis

doi: 10.12259/j.issn.2095-610X.S20230912

1.
School of Pharmaceutical Sciences，Dali University，Dali Yunnan 671000
2.
The Third People’s Hospital of Kunming/Yunnan Provincial Infectious Disease Clinical Medical Center，Kunming Yunnan 650041，China

Received Date: 2023-06-16
Available Online: 2023-09-23
Publish Date: 2023-09-30

Abstract

Abstract

Objective To systematically evaluate the efficacy and safety of different bronchoscopic intervention methods combined with the conventional anti-tuberculosis regimen in the treatment of tracheobronchial tuberculosis （TBTB）, and to provide the evidence-based reference for clinical practice. Methods Computer search PubMed, Web of Science, EMBase, CNKI, Wanfang Database, VIP database, randomized controlled trials （RCTS） of different bronchoscopic interventions （local administration, cryotherapy, and atomization） combined with conventional anti-tuberculosis therapy were collected. After the data extraction and quality evaluation, network meta-analysis was performed using Stata 16.0 software. Results A total of 38 RCTS were included, involving a total of 3114 patients and three interventions （conventional + local administration, conventional+ cryotherapy, conventional + local administration + atomization）. Compared with the conventional treatment, conventional+ cryotherapy, conventional + local administration, conventional + local administration + atomization could significantly improve the total clinical response rate （P < 0.05）. The results of mesh Meta ranking were conventional + local administration + atomization > conventional + local administration > conventional + cryotherapy > conventional. Compared with the conventional treatment, conventional + cryotherapy, conventional + local administration, conventional + local administration + atomization could significantly improve the effective rate of fiberoptic bronchoscopy （P < 0.05）. The results of mesh Meta ranking were conventional + local administration > conventional + local administration + atomization > conventional + cryotherapy > conventional. Compared with the conventional treatment, conventional + local administration, conventional + local administration + atomization could significantly improve the sputum negative conversion rate at the end of 8 weeks after the treatment （P < 0.05）. Compared with conventional + cryotherapy, conventional + local administration could significantly improve the sputum negative conversion rate at the end of 8 weeks after treatment （P < 0.05）. The results of mesh Meta ranking were conventional + local administration > conventional + local administration + atomization > conventional + cryotherapy > conventional. Compared with the conventional treatment, conventional + local administration could significantly improve the sputum negative conversion rate at the end of 24 weeks after treatment （P < 0.05）. The results of mesh Meta ranking were conventional + local administration > conventional + local administration + atomization > conventional + cryotherapy > conventional. There was no statistically significant difference in the incidence of adverse reactions among all groups （P > 0.05）. Conclusion The conventional + local administration + atomization scheme has the most significant improvement effect, while the conventional + local administration scheme has the best effect in improving the effective rate under bronchoscopy. In TBTB patients, the conventional + local administration + atomization regimen can accelerate the sputum to negative in the early stage, but the conventional + local administration regimen can accelerate the conversion of sputum to negative in the long-term treatment. Bronchoscopic intervention on the basis of conventional anti-tuberculosis therapy does not increase adverse reactions and has the good safety. However, this study needs to be further verified by including more high-quality, double-blind RCTS.
- Network meta-analysis,
- Bronchoscopic interventional therapy,
- Tracheobronchial tuberculosis,
- Curative effect,
- Systematic evaluation

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References(52)

References

[1]	中华医学会结核病学分会,《中华结核和呼吸杂志》编辑委员会. 气管支气管结核诊断和治疗指南(试行)[J]. 中华结核和呼吸杂志,2012,35(8):581-587.
[2]	李莹,曹益瑞,陶红竹,等. 气管支气管结核的局部药物治疗进展[J]. 中国防痨杂志,2021,43(10):1096-1101.
[3]	Ding H,Hu G L,Zheng X Y,et al. The method quality of cross-over studies involved in cochrane systematic reviews[J]. PLoS One,2015,10(4):e0120519. doi: 10.1371/journal.pone.0120519
[4]	田江华,戴元荣,颜孙舜,等. 经支气管镜局部药物灌注治疗气管支气管结核的临床研究[J]. 中国防痨杂志,2014,36(6):494-497.
[5]	高鸿,赵金辅. 支气管镜下局部用药法联合常规抗结核疗法治疗气管支气管结核的疗效[J]. 当代医药论丛,2021,19(11):80-81.
[6]	张新宝,周瑛,张毕玲. 支气管镜注入治疗支气管结核72例临床疗效分析[J]. 临床肺科杂志,2015,20(11):1960-1962.
[7]	张德利,张彦. 支气管镜下局部治疗支气管结核临床分析[J]. 临床医药文献电子杂志,2019,6(77):81.
[8]	崔金霞. 纤维支气管镜给药治疗支气管结核的临床研究[J]. 大健康,2021,8(3):131-132.
[9]	符少平,邱晨,孔焱. 非瘢痕狭窄型支气管内膜结核局部治疗的疗效观察[J]. 山东医药,2009,49(17):91-92.
[10]	肖斌. 经电子支气管镜局部注药治疗支气管结核的近远期疗效对照分析[J]. 影像研究与医学应用,2020,4(17):165-166.
[11]	潘丽. 经纤维支气管镜局部化疗治疗气管支气管结核的疗效[J]. 中外医学研究,2013,11(34):48-49.
[12]	郑飞. 经纤维支气管镜局部注药治疗支气管结核的疗效观察[J]. 河北医药,2013,35(23):3556-3557.
[13]	刘宗道,敬军. 经纤维支气管镜治疗痰菌阳性的支气管内膜结核的疗效分析[J]. 中国内镜杂志,2002,8(7):21-22.
[14]	韩彩丽. 经纤维支气管镜注药治疗气管及支气管结核的临床疗效观察[J]. 内蒙古医学杂志,2013,45(7):799-800.
[15]	叶涛生,张培泽,曾旋,等. 经支气管镜治疗淋巴结瘘型支气管结核的效果分析[J]. 新发传染病电子杂志,2018,3(4):202-205.
[16]	孙明华. 局部给药治疗支气管结核的临床疗效[J]. 临床肺科杂志,2017,22(9):1716-1718,1721.
[17]	陈廷宪,黄祖军,冯晓红. 抗结核联合电子支气管镜治疗支气管结核患者的效果及安全性分析[J]. 中国当代医药,2021,28(22):62-65.
[18]	胡翠兰,刘纯钢,袁艳梅. 联合治疗支气管结核的疗效观察[J]. 临床肺科杂志,2015,20(2):363-364.
[19]	陈艳,王波,蒲青,等. 纤维支气管镜局部治疗支气管内膜结核的疗效观察[J]. 西部医学,2009,21(9):1480-1481.
[20]	王枝梅. 纤维支气管镜下局部给药治疗支气管结核疗效观察[J]. 中国实用医药,2012,7(35):89-90.
[21]	张胜堂,唐炳俭,张晓伟,等. 纤维支气管镜下局部注射治疗支气管内膜结核的临床疗效观察[J]. 当代医学,2020,26(25):31-33.
[22]	朱红涛. 纤支镜局部注射药物联合2HRSZ/4HR方案治疗支气管结核的短期随访研究[J]. 实用医药杂志,2020,37(6):510-512. doi: 10.14172/j.issn1671-4008.2020.06.009
[23]	杨新建. 纤支镜气管内注入异烟肼联合利福平治疗支气管结核的临床观察[J]. 世界最新医学信息文摘,2021,21(85):129-130.
[24]	张含琼,李强. 异烟肼治疗气管支气管结核的临床疗效与安全性观察[J]. 检验医学与临床,2016,13(12):1656-1658.
[25]	张廷梅,熊敏,吴鉴文,等. 支气管结核单纯化疗和介入综合治疗近期效果观察[J]. 中国防痨杂志,2008,30(3):206-209.
[26]	刘斌远,史海霞,吕广波,等. 支气管结核经纤维支气管镜介入治疗与单纯全身化疗对比研究[J]. 河北医药,2012,34(6):852-853.
[27]	李史来,黄智祥,林少云,等. 支气管镜辅助治疗支气管内膜结核的观察[J]. 中国热带医学,2013,13(12):1535-1537.
[28]	庄辉,丁园国,藏千静,等. 支气管镜局部注射化疗在支气管结核患者治疗中的应用价值[J]. 中国社区医师,2019,35(13):105.
[29]	付娟. 支气管镜下局部灌药联合全身化疗治疗支气管结核的疗效及应用[J]. 黑龙江医学,2017,41(7):649-651.
[30]	程耀强,陀子能. 支气管镜下局部治疗联合全身抗结核治疗支气管结核疗效分析[J]. 中国实用医药,2021,16(26):28-31.
[31]	如克亚木·阿不都沙拉木,古力米热·依明,麦不班姆·依不拉依木,等. 电子支气管镜下冷冻结合抗结核药物治疗支气管结核的效果[J]. 临床医学研究与实践,2020,5(3):51-52.
[32]	刘荣奎. 电子支气管镜下冷冻治疗支气管结核的疗效及安全性分析[J]. 中国医疗器械信息,2016,22(6):63-64.
[33]	蒋凛. 经支气管镜冷冻治疗支气管结核疗效分析[J]. 江西医药,2019,54(5):503-504,507.
[34]	王志刚,刘媛媛. 经纤维支气管镜介入冷冻联合其他方法治疗气管支气管结核的疗效及不良反应分析[J]. 中国防痨杂志,2019,41(5):569-574.
[35]	王莉,徐爱晖. 经纤支镜介入冷冻治疗支气管结核的疗效分析[J]. 临床肺科杂志,2013,18(8):1450-1452.
[36]	姜心成. 经支气管镜介入冷冻治疗支气管结核的临床效果观察[J]. 中国实用医药,2018,13(2):32-33.
[37]	刘明,马英莲,魏国月,等. 支气管结核患者经纤支镜介入冷冻治疗的疗效分析[J]. 河北医学,2018,24(12):2051-2054.
[38]	于丹. 支气管镜介入冷冻治疗支气管结核临床研究[J]. 中国现代医生,2016,54(8):82-84.
[39]	黄自强,吴俊杰,吴琼华. 纤维支气管镜下支气管结核冷冻疗法对肉芽增殖型支气管结核的疗效与安全性[J]. 安徽医学,2021,42(3):257-260.
[40]	陆兰英,靖秋生,王卫华. 经纤维支气管镜注药联合雾化吸入治疗支气管结核的疗效观察[J]. 中国防痨杂志,2010,32(2):104-107.
[41]	谭红玉. 经可弯曲纤维支气管镜局部注药联合雾化吸入结核药物方法治疗支气管内膜结核的疗效观察[J]. 中国伤残医学,2014,22(6):152-154.
[42]	Su Z,Cheng Y,Wu Z,et al. Incidence and predictors of tracheobronchial tuberculosis in pulmonary tuberculosis: A multicentre,large-scale and prospective study in Southern China[J]. Respiration,2019,97(2):153-159. doi: 10.1159/000492335
[43]	《中华结核和呼吸杂志》编辑委员会. 支气管结核的几点专家共识[J]. 中华结核和呼吸杂志,2009,32(8):568-571.
[44]	Momin M A M,Rangnekar B,Sinha S,et al. Inhalable dry powder of bedaquiline for pulmonary tuberculosis: In vitro physicochemical characterization,antimicrobial activity and safety studies[J]. Pharmaceutics,2019,11(10):502. doi: 10.3390/pharmaceutics11100502
[45]	Rangnekar B,Momin M A M,Eedara B B,et al. Bedaquiline containing triple combination powder for inhalation to treat drug-resistant tuberculosis[J]. Int J Pharm,2019,570(10):118689.
[46]	Shao Z,Tai W,Qiu Y,et al. Spray-dried powder formulation of capreomycin designed for inhaled tuberculosis therapy[J]. Pharmaceutics,2021,13(12):2044. doi: 10.3390/pharmaceutics13122044
[47]	Rai P Y,Sansare V A,Warrier D U,et al. Formulation,characterization and evaluation of inhalable effervescent dry powder of Rifampicin nanoparticles[J]. Indian J Tuberc,2023,70(1):49-58. doi: 10.1016/j.ijtb.2022.03.007
[48]	Bax H I,de Steenwinkel J E,Ten Kate M T,et al. Colistin as a potentiator of anti-TB drug activity against Mycobacterium tuberculosis[J]. J Antimicrob Chemother,2015,70(10):2828-2837. doi: 10.1093/jac/dkv194
[49]	Stewart I E,Lukka P B,Liu J,et al. Development and characterization of a dry Powder formulation for anti-tuberculosis drug spectinamide 1599[J]. Pharm Res,2019,36(9):136. doi: 10.1007/s11095-019-2666-8
[50]	Gonzalez-Juarrero M,Lukka P B,Wagh S,et al. Preclinical evaluation of inhalational spectinamide-1599 therapy against tuberculosis[J]. ACS Infect Dis,2021,7(10):2850-2863. doi: 10.1021/acsinfecdis.1c00213
[51]	张慧珊,陈熙泼,叶乐平,等. 经支气管镜冷冻介入在儿童气管支气管结核诊疗中的临床应用[J]. 中华儿科杂志,2021,59(11):963-967.
[52]	Ni C,Yu H,Han X,et al. Clinical analysis of bronchoscopic cryotherapy in 156 pediatric patients[J]. Pediatr Int,2017,59(1):62-67. doi: 10.1111/ped.13088

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