【Cochrane简语概要】补锌作为2至59个月儿童肺炎抗生素治疗的辅助疗法

在低收入国家，肠胃炎和呼吸道感染（特别是肺炎）是最常见的两种死亡原因。预防性补锌可纠正导致免疫缺陷的任何不足，事实上，一些证据表明，预防性补锌可降低因传染性疾病（特别是肺炎）而导致的儿童发病率和死亡率。肺炎是肺部的炎症，由病毒、细菌或其它微生物引起。评价锌补充剂作为肺炎辅助治疗手段的疗效研究有限，且这些研究显示出不同结果。本综述的目的是评价锌补充疗法作为2至59个月儿童肺炎抗生素治疗的辅助疗效。

（图片来源于网络）

本综述作者发现四项高质量随机对照试验，评价了锌补充剂作为儿童肺炎抗生素治疗的辅助疗效。这些研究在孟加拉国、尼泊尔和印度进行，共3267名2至35个月大的儿童被随机分组，接受锌或安慰剂进行治疗。所有研究均未报告严重不良事件。分析未显示出补锌对病人的临床呼吸急促（呼吸速率>50次/分钟）和胸廓内收恢复时间有显著疗效。分析还显示此干预对出院时间无显著影响。本综述提供的证据不足以推荐将补锌作为2至35个月的儿童肺炎的抗生素治疗的标准辅助疗法。

结论: 

本综述提供的证据不足以建议将锌补充剂作为2至35个月的儿童肺炎抗生素治疗的标准辅助疗法。

翻译：梁士兵，审校：张英英、鲁春丽；编辑排版：张晓雯，北京中医药大学循证医学中心

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【Cochrane Plain Language Summary】Zinc supplementation as an adjunct to antibiotics in the treatment of pneumonia in children two to 59 months of age

Gastroenteritis and respiratory infections (particularly pneumonia) are the two most common causes of death in low-income countries. Preventive zinc supplementation may correct any deficiency leading to immunodeficiency and indeed some evidence suggests that preventive zinc supplementation may reduce child mortality and morbidity from infectious diseases, particularly pneumonia. Pnumeonia is the inflammation of the lungs and is caused by viruses, bacteria or other microorganisms. Studies evaluating the impact of zinc supplementation as an adjunct in the management of pneumonia are limited and have shown variable results. The aim of this review is to evaluate the role of zinc supplementation, as an adjunct to antibiotics, in the treatment of pneumonia in children aged two months to 59 months.

The review authors found four randomised control trials of adequate quality evaluating the impact of zinc supplementation as an adjunct to antibiotics for pneumonia in children. These studies were conducted in Bangladesh, Nepal and India, in which 3267 children aged two to 35 months were randomly assigned to receive zinc or placebo. No serious adverse events were observed. Analysis did not show any significant effect on the clinical recovery of patients in terms of time-to-recovery from tachypnoea (respiratory rate > 50 breaths per minute) and time-to-recovery from chest indrawing. It also showed non-significant effects of the intervention on the time-to-hospital discharge. Evidence provided in this review is insufficient to recommend use of zinc as an adjunct to standard antibiotic therapy for pneumonia in children aged two to 35 months.

Authors' conclusions: 

Evidence provided in this review is insufficient to recommend the use of zinc as an adjunct to standard antibiotic therapy for pneumonia in children aged two to 35 months.

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