Page 52 - EJMO-9-2

Eurasian Journal of
Medicine and Oncology TCM regulates gut microbiota in pediatric MP pneumonia

and can involve multiple organ systems, resulting in a patients with mild and severe pneumonia, with no
wide range of extrapulmonary manifestations. MPP is restrictions on gender or case origin
1-4
endemic worldwide, with regional pandemics occurring (3). Intervention measures: Measures in the intervention
every 3 – 8 years. In the past few years, there has been a group were focused on utilizing Chinese herbal
5
trend of increased incidence, particularly among school- medicine either solely or in conjunction with Western
age children. For treatment, macrolides are the drugs of medicine
choice, but their widespread use has led to the development (4). Results: The main outcome was the overall clinical
of genetic mutations in M. pneumoniae, resulting in drug effectiveness rate. Secondary outcomes included
resistance. New tetracyclines are effective in improving changes in intestinal microbiota counts, time to
6
symptoms but are prone to causing adverse reactions. resolution of rales, serum levels of the inflammatory
7
Antibiotic therapy can also lead to gastrointestinal cytokine interleukin (IL)-6, and adverse effects
and renal damage, as well as other adverse reactions in (5). Criteria for clinical effectiveness: The clinical
children. Therefore, improving the safety and effectiveness effectiveness was categorized as follows: disappearance
8
of treatments for M. pneumoniae remains an important of fever, cough, sputum, lung wet rales, and other
area for further exploration and research. symptoms; post-treatment was considered “markedly
It has been found that beneficial intestinal bacteria effective;” symptom improvement after treatment
9
are effective in reducing pathogenic bacteria, restoring was classified as “effective;” lack of symptom relief
the gut mucosal barrier, and reducing the inflammatory after treatment was deemed “ineffective.” The overall
response in children with MPP. Meanwhile, traditional effectiveness rate was calculated as the sum of the
Chinese medicine (TCM) has shown particular markedly effective and effective rates. 16
benefits in treating MPP and has yielded some positive 2.2. Search strategy
outcomes 10,11 . However, it should be noted that the
number of randomized controlled trials (RCTs) Comprehensive searches were conducted in several databases,
investigating the treatment of MPP from a gut flora including PubMed, Embase, Chinese Biomedical Literature
perspective is still relatively small. In addition, some Database (SinoMed), Cochrane Library, China National
studies have issues, such as insufficient quality, and there Knowledge Infrastructure, Wanfang, and VIP. Each database
is a lack of a comprehensive and objective systematic was searched for articles published from its inception until
review and meta-analysis. Therefore, the aim of this March 2024, including both English and Chinese-language
study is to rigorously assess and validate the effectiveness articles. The retrieval strategy employed Medical Subject
and safety of TCM modulation of intestinal microbiota Headings and freeform terms. Detailed retrieval strategies
in treating MPP in children through high-quality clinical for each database are provided in Table S2.
RCTs. We employ systematic review and meta-analysis 2.3. Research selection
to provide reliable, evidence-based medical support for
clinical practice. The retrieved documents were imported into EndNote,
a reference management tool, to eliminate duplicates.
2. Materials and methods Subsequently, the remaining documents were read in full
This study has been registered with the International by two independent reviewers and re-screened based on
Prospective Register of Systematic Reviews, under the inclusion and exclusion criteria. Disagreements were
registration number CRD42025632325. After registration, resolved by a third party, and the final screening results
a meta-analysis was conducted following the guidelines were double-checked for accuracy.
of the Preferred Reporting Items for Systematic Reviews Data pertinent to the literature were extracted using an
and Meta-Analyses (PRISMA) 2020 and the Cochrane Excel spreadsheet, encompassing: (i) fundamental details
12
Handbook for Systematic Reviews of Interventions. The of the included studies, such as the principal author’s name
13
PRISMA checklist, which has been thoroughly completed, and publication year; (ii) primary characteristics of the
is appended in Table S1. study subjects, including age, gender, and the duration
of illness; (iii) details of the interventions, including the
2.1. Eligibility criteria specific implementation process, medications used, and
Studies that met the following criteria were considered treatment duration; (iv) key elements for assessing bias risks
eligible for analysis: within the studies, such as the comparability of baseline
(1). Research type: RCTs characteristics, group randomization, and implementation
(2). Participants: Participation must meet the diagnostic of blinding; and (v) outcome data, including overall
criteria for MPP in pediatric patients, 14,15 including clinical effectiveness, time to resolution of rales, serum

Volume 9 Issue 2 (2025) 44 doi: 10.36922/ejmo.8602