The Efficacy Of Adjunctive Corticosteroids In The Treatment Of Tuberculous Pleurisy: A Meta-analysis

Objective: To evaluate the efficacy and safety of oral glucocorticoids in the treatment of tuberculous pleurisy.METHODS: Computer searched PubMed,Medline,EMbase database,Science Direct database,China Journal Full-text Database(CNKI),Wanfang Medical Journal database for related research on oral glucocorticoid treatment of tuberculous pleurisy,based on strict quality evaluation.Meta analysis was performed using RevMan 5.3 software.RESULTS: A total of 13 studies were included,including 1339 subjects,published in 1988-2018,and the search languages were Chinese and English.Meta-analysis showed that the time of improvement of clinical symptoms in patients with tuberculous pleurisy was significantly shorter than that of the control group(P<0.00001).The short-term(4 weeks)complete rate of pleural fluid was high compared with the control group,the difference was statistically significant(P=0.0007),pleural thickening adhesion was lower than the control group,the difference was statistically significant(P<0.00001),and the adverse reaction was higher than thecontrol group(P<0.001).Conclusion: Our results suggest that adjunctive Oral corticosteroid reduced the risk of residual pleural fluid at 4 weeks and the number of days to symptom improvement,and prevent pleural thickening adhesion,but the incidence of adverse reactions will increase.