Meta-analysis Of Clinical Efficacy Of Vitamin A And Vitamin D In The Treatment Of Children With Pneumonia

Objective: To comprehensively evaluate the clinical effects of vitamin A（vitamin A,Vit A）and vitamin D（vitamin D,Vit D）supplementation on children with pneumonia.Methods: Randomized controlled trials（RCT）on Vit A and Vit D adjuvant treatment for pediatric pneumonia published by NCBI,Pub Med,CNKI and Wanfang database were randomized as of July 31,2018.According to the inclusion criteria and exclusion criteria,the literature was screened and relevant data were extracted,and meta-analysis was performed using stata12.0software.Evaluate a single Vit A or Vit D adjuvant treatment of childhood pneumonia with Odd Ratio（OR）,Relative Risk（RR）,Standardized Mean Difference（SMD）,and 95% confidence interval（CI）.Results: The final inclusion of the Vit A study was 28 RCTs,including 4611 subjects,2301 subjects in the control group,and 2310 subjects in the experimental group.The Vit D study included 19 RCTs,including 2994 subjects,1568 subjects in the control group,and 1426 subjects in the experimental group.Meta-analysis showed that compared with the control group,Vit A can significantly improve the clinical total effective rate of children with pneumonia [OR=3.07,95%CI=（2.00,4.72）,P<0.05],shorten the duration of fever in children [SMD=-0.46,95%CI=（-0.71,-0.21）,P<0.05],shorten the cough duration [SMD=-1.08,95%CI=（-1.37,-0.79）,P<0.05],shorten the lung departmental voice duration[SMD=-0.76,95%CI=（-1.08,-0.44）,P<0.05] and shorten the hospitalization time [SMD=-0.73,95%CI=（-1.23,-0.22）,P<0.05].However,supplementation with Vit A did not reduce the mortality rate [OR=1.10,95%CI=（0.6,2.04）,P>0.05].Supplementation with Vit D can significantly improve the clinical total effective rate of children with pneumonia [OR=8.11,95%CI=（5.57,11.8）,P<0.05],shorten the duration of fever in children [SMD=-1.01,95%CI=（-1.70,-0.32）,P<0.05],cough duration [SMD=-1.19,95%CI=（-1.53,-0.85）,P<0.05],lung voice duration [SMD=-1.09,95%CI=（-1.53,-0.65）,P<0.05] and hospital stay [SMD=-1.0,95%CI=（-1.38,-0.61）,P<0.05].Conclusions:（1）Vit A has a positive clinical effect in the treatment of children with pneumonia,but the duration of fever,the disappearance of lung murmur,and tlength of hospitalization are highly heterogeneous in RCT studies,while the regional（Asia-African/European and American）differences may be the source of heterogeneity;（2）Vit D adjuvant treatment of children with pneumonia has a positive clinical effect,which can be applied in clinical applications.Given the limitations of this study,further validation is required.