Meta-analysis of conventional hypoglycemic and anti-tuberculosis therapy combined with thymosin α1 in the treatment of pulmonary tuberculosis complicated with diabetes

doi:10.19983/j.issn.2096-8493.2024005

Abstract

Abstract:

Objective: To evaluate the efficacy of conventional hypoglycemic and anti-tuberculosis therapy combined with thymosin α1 in pulmonary tuberculosis patients complicated with diabetes mellitus. Methods: Relevant literature was searched for in both Chinese and English from PubMed, Web of Science, Embase, CNKI, Wanfang Database, etc. from January 1, 2010 to June 30, 2022, with Chinese search terms including thymosin α1, Tα1, tuberculosis, diabetes, and the English search terms including Thymosin alpha 1, Tα1, Tuberculosis, Diabetes mellitus, Diabetes. he results of randomized controlled trial of pulmonary tuberculosis patients complicated with diabetes were collected, all the patients were treated with conventional hypoglycemic and anti-tuberculosis therapy combined with thymosin α1. Results: A total of 1117 references were retrieved, and 13 were ultimately included in the study; the 685 included patients were divided into the observation group (n=335, combined with thymosin α1) and the control group (n=350, conventional hypoglycemic and anti-tuberculosis treatment). Meta analysis showed that, of the observation group, the treatment efficacy rate (OR (95%CI)=4.08 (2.77-6.02)), sputum negative conversion rate (OR (95%CI)=4.61 (3.21-6.63)), and lesion absorption rate (OR (95%CI)=5.06 (3.19-8.04)) were significantly better than those of the control group; the CD4⁺T cell levels after treatment (standardized mean difference (SMD)=2.07, 95%CI: 1.37-2.77, P<0.001) and CD3⁺T cell levels (SMD (95%CI)=2.33 (0.98-3.67), P=0.001) were significantly better than those in the control group; after treatment, the CD8⁺T cell level was significantly lower than that in the control group (SMD (95%CI)=-2.21 (-2.95--1.48), P<0.001), and the CD4⁺/CD8⁺ ratio was significantly increased (SMD (95%CI)=1.25 (0.73-1.77), P<0.001). Conclusion: Conventional hypoglycemic and anti-tuberculosis combination with thymosin α1 treatment for pulmonary tuberculosis patients complicated with diabetes could improve the treatment efficiency, focus absorption rate and sputum negative conversion rate; with the treatment, the patient’s CD4⁺, CD3⁺T cell levels, and CD4⁺/CD8⁺ratio have all increased.

Key words: Tuberculosis, pulmonary, Diabetes mellitus, Thymus hormones, Treatment outcome, Meta-analysis

CLC Number:

R521

Li Dan, Zhang Yuhua, Chen Shengyu. Meta-analysis of conventional hypoglycemic and anti-tuberculosis therapy combined with thymosin α1 in the treatment of pulmonary tuberculosis complicated with diabetes[J]. Journal of Tuberculosis and Lung Disease , 2024, 5(2): 148-157. doi: 10.19983/j.issn.2096-8493.2024005

Figures/Tables 7

文献编号	发表年份	抽样时间	组别	例数	病程 (月, $x ˉ$ ±s)	年龄 (岁, $x ˉ$ ±s)	胸腺肽α1 治疗疗程	男性患者(例)	研究类型	结果评估
文献[6]	2015	2011年3月至 2014年3月	观察组	27	4.95±3.41	66.73±10.15	6个月	15	随机对照试验	①②③ ④⑤⑥
			对照组	27	4.95±3.41	66.73±10.15		15
文献[15]	2020	2018年9月至 2019年12月	观察组	32	6.41±0.94	52.31±7.34	6个月	17	随机对照试验	②③④ ⑤⑥
			对照组	32	6.56±0.88	51.89±7.61		18
文献[16]	2012	2008年1月至 2009年6月	观察组	68	4.70±3.50	53.80±11.60	3个月	44	病例对照研究	②③④ ⑤⑥
			对照组	88	5.20±3.10	52.30±12.60		58
文献[7]	2019	2016年3月至 2018年1月	观察组	53	3.65±1.02	53.26±4.11	2个月	20	随机对照试验	①②⑤ ⑥⑦
			对照组	53	3.81±1.12	54.11±4.26		23
文献[17]	2014	2008年2月至 2012年4月	观察组	38	6~18	41.20±6.50	6个月	28	随机对照试验	②③⑤ ⑥⑦
			对照组	38	5~15	42.70±5.70		26
文献[8]	2021	2018年10月至 2020年8月	观察组	40	4.82+1.16	54.26±9.92	3个月	25	随机对照试验	①②③ ⑤⑥⑦
			对照组	40	4.91±1.09	53.89±9.75		23
文献[9]	2018	2015年3月至 2016年12月	观察组	42	9.80±2.30	44.50±6.20	6个月	28	随机对照试验	①②③ ④⑤⑥
			对照组	42	9.80±2.20	44.70±6.10		26
文献[10]	2016	2014年5月至 2016年5月	观察组	26	8.94±3.12	55.01±8.13	6个月	12	随机对照试验	①⑤⑥
			对照组	26	9.07±3.25	54.26±8.71		16
文献[11]	2017	2016年1—12月	观察组	63	9.21±3.81	55.32±8.32	6个月	36	随机对照试验	①⑤⑥
			对照组	63	9.07±3.25	54.62±8.17		38
文献[12]	2020	2018年1—10月	观察组	43	15.64±3.82	63.77±8.55	6个月	27	随机对照试验	①②③ ④⑤⑥
			对照组	43	16.10±4.06	61.70±6.50		23
文献[13]	2021	2017年12月至 2019年6月	观察组	40	5.40±1.50	68.90±4.60	3个月	24	随机对照试验	①⑤⑥
			对照组	40	5.30±1.60	68.20±4.30		23
文献[18]	2021	2016年1月至 2019年12月	观察组	43	1.75±0.34	50.23±2.45	6个月	23	病例对照研究	②④⑤ ⑥⑦
			对照组	43	1.80±0.31	50.31±2.40		21
文献[14]	2022	2017年1月至 2018年1月	试验组	60	6.85±2.78	46.68±9.44	3个月	36	随机对照试验	①②③④ ⑤⑥⑦
			对照组	60	6.77±2.12	47.53±9.62		40

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