Adjuvant Effect of Mycobacterium Vaccae on Treatment of Recurrent Treated Pulmonary Tuberculosis: A Meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

FAN Miaoyi ¹ ,  CHEN Xuerong ¹ , WANG Ke ¹ , MAO Hui ¹ , FENG Yulin ¹ , TANG Xiaoyan ¹ , WANG Li ²

1. Department of Respiratory Medicine, West China Hospital, Sichuan University Chengdu 610041, China2. Chinese Evidence-Based Medicine Center, West China Hospital of Sichuan University, Chengdu 610041, China;

Corresponding author：

CHEN Xuerong, Email: milkmilk530@163.com

Keywords：

Mycobacterium vaccae; Pulmonary tuberculosis; Immunotherapy; Meta-analysis

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Objectives 　To evaluate the effect and safety of mycobacterium vaccae in the treatment of recurrent treated pulmonary tuberculosis.
Methods 　We searched PubMed (1997 to 2006), VIP (1997 to 2006), Wanfang database (1997 to 2006), The Cochrane Central Register of Controlled Trials (Issue 4, 2006) and the National Research Register (1996 to 2006). Randomized controlled trials comparing the mycobacterium vaccae immunotherapy group and the control group were included. Two reviewers independently performed data extraction and quality assessment. Data were analyzed using RevMan 4.2.2 software by The Cochrane Collaboration.
Results 　Eleven high quality trials were included. Meta-analyses showed that mycobacterium vaccae immunotherapy plus chemotherapy resulted in higher sputum negative conversion rate (RR=1.36, 95%CI 1.21 to 1.54), higher lesion absorption rate (RR=1.39, 95%CI 1.13 to 1.72), and lower lesion non-absorption rate (RR=0.46, 95%CI 0.36 to 0.60), compared with the control group. These differences were all statistically significant. No serious adverse events were reported. 　
Conclusion 　As an adjunct to chemotherapy, mycobacterium vaccae is helpful for patients with recurrent treated pulmonary tuberculosis in terms of improving cell-medicated immunity, sputum negative conversion and X-ray manifestation. More high quality studies are needed for further analysis.

Citation： FAN Miaoyi,CHEN Xuerong,WANG Ke,MAO Hui,FENG Yulin,TANG Xiaoyan,WANG Li. Adjuvant Effect of Mycobacterium Vaccae on Treatment of Recurrent Treated Pulmonary Tuberculosis: A Meta-analysis. Chinese Journal of Evidence-Based Medicine, 2007, 07(6): 449-455. doi: Copy

1.	Sun ZP, Liu H. The present research of the effect of Mycobacterium vaccae on prevention and treatment of tuberculosis. The Journal of The Chinese Antituberculosis Association, 2006, 28(6): 413-415.
2.	Department of Disease Control of Ministry of Health. Guideline on Enforcement of Chinese Tuberculosis Control Program, 2002. 3.
3.	Luo YA, Lu SH, Guo SL, et al. Immunotherapeutic effect of Mycobacterium vaccae on multi-drug resistant pulmonary tuberculosis. Chinese Journal of Tuberculosis and Respiratory Diseases, 2000, 23(2): 85-88.
4.	Song XD, Ren YW, Zhu H, et al. the efficacy of Mycobacterium vaccae on 36 cases of multi-drug resistant pulmonary tuberculosis. Clinical Medicine of China, 2002, 11(18): 1006.
5.	Zheng RT, Pan ZW. Clinical observation on therapeutic efficacy of Mycobacterium vaccae in treating the elderly patients with bacterium positive retreated pulmonary tuberculosis, Ningxia Med J, 2005, 27(1): 30-32.
6.	Zhou ZH, Shen HL. The clinical analysis of the adjuvant efficacy of Mycobacterium vaccae on recurrent smear-positive pulmonary tuberculosis. China Tropical Medicine, 2005, 5(5): 1009-1010,1015.
7.	Shangguan ZX, Zhou JY. The clinical observation on the effect of Mycobacterium vaccae plus chemotherapy on recurrent smear-positive pulmonary tuberculosis. Zhejiang medical Journal, 2005, 3(27): 236-238.
8.	Rao PA, Gan XF. The effect of chemotherapy plus Mycobacterium vaccae vaccine in treatment of 30 cases with recurrent pulmonary tuberculosis. Journal of Clinical Pulmonary Medicine, 2005, 5(10): 602.
9.	Yao HB, Sang HZ, Guo L, et al. The observation of the effect of the treatment of multi-drug resistant pulmonary tuberculosis with M Vaccae. The Journal of The Chinese Antituberculosis Association, 2005, 6(27): 389-392.
10.	Liu YH. The observation of the adjuvant efficacy of Mycobacterium vaccae on multi-drug resistant pulmonary tuberculosis. Chinese Journal of Primary Medicine and Pharmacy, 2006, 3(13): 492-493.
11.	Wang JY, Lin DW. The effect of Mycobacterium vaccae on multi-drug resistant pulmonary tuberculosis. Acta Medicinae Sinica, 2006, 3(19): 443-445.
12.	Zou LN, Shao YD,Wang RW, et al. The effect of Mycobacterium vaccae on 38 senior cases of recurrent smear-positive pulmonary tuberculosis. Journal of Clinical Pulmonary Medicine, 2006, 3(11): 377-378.
13.	Wu GD, Li LH. The effect of Mycobacterium vaccae plus Dipasic on 177 cases with recurrent pulmonary tuberculosis. The Journal of The Chinese Antituberculosis Association, 2006, supplement(28): 32.
14.	孙照平, 刘辉.母牛分枝杆菌菌苗用于结核病防治的研究现状.中国防痨杂志,2006, 28(6): 413-415.
15.	World Health Organization. Treatment of tuberculosis: Guidelines for national programmes.WHO/CDS/ TB/ 2003.313. Geneva: WHO, 2003.
16.	卫生部疾病控制司.中国结核病防治规划实施工作指南, 2002. 3.
17.	Jüni P, Altman DG, Egger M. Systematic reviews in health care: Assessing the quality of controlled clinical trials. BMJ, 2001, 323: 42–46.
18.	Alderson P, Green S, Higgins JPT. Cochrane Reviewers’ Handbook 4.2.2[updated March 2004]. In: The Cochrane Library, Issue 1, 2004.
19.	罗永艾, 卢水华, 郭述良, 等. 母牛分枝杆菌菌苗在难治性肺结核治疗中的作用.中华结核和呼吸杂志, 2000, 23(2): 85-88.
20.	宋小冬, 任彦薇, 朱红, 等. 微卡方案治疗耐多药肺结核36例疗效观察.中国综合临床, 2002, 11(18): 1006.
21.	郑如添, 潘治文. 母牛分枝杆菌菌苗辅助治疗老年复治菌阳肺结核临床观察.宁夏医学杂志, 2005, 27(1): 30-32.
22.	周志红,申红连.母牛分枝杆菌菌苗辅助治疗复治菌阳肺结核的临床分析.中国热带医学,2005,5(5): 1009-1010,1015.
23.	上官宗校,周建英.微卡联合化疗药物治疗复治涂阳肺结核的疗效观察.浙江医学, 2005, 3(27): 236-238.
24.	饶平安,甘先锋.化疗药物联合微卡治疗涂阳复治肺结核30例疗效观察.临床肺科杂志,2005, 5(10): 602.
25.	姚恒波,尚好珍,郭磊,等.微卡辅助治疗耐多药肺结核的临床研究.中国防痨杂志,2005, 6(27): 389-392.
26.	刘月花. 微卡菌苗辅助治疗多种耐药肺结核的疗效观察.中国基层医药, 2006, 3(13): 492-493.
27.	王继业,林定文.母牛分枝杆菌菌苗在耐多药肺结核治疗中的作用.华夏医学, 2006, 3(19): 443-445.
28.	邹良能,邵以德,王人委,等.微卡治疗老年复治涂阳肺结核38例疗效观察.临床肺科杂志, 2006, 3(11): 377-378.
29.	吴高达,李力鸿. 微卡与力克菲蒺合用对177例复治肺结核临床疗效观察.中国防痨杂志, 2006, 增刊(28): 32.
30.	Stanford JL, BahR GM, Rook GAM,et al.Immunotherapy with Mycobacterium vaccae as an adjunct to chemotherapy in the treatment of pulmonary tuberculosis.Tubercle,1990,71:87.

1. Sun ZP, Liu H. The present research of the effect of Mycobacterium vaccae on prevention and treatment of tuberculosis. The Journal of The Chinese Antituberculosis Association, 2006, 28(6): 413-415.
2. Department of Disease Control of Ministry of Health. Guideline on Enforcement of Chinese Tuberculosis Control Program, 2002. 3.
3. Luo YA, Lu SH, Guo SL, et al. Immunotherapeutic effect of Mycobacterium vaccae on multi-drug resistant pulmonary tuberculosis. Chinese Journal of Tuberculosis and Respiratory Diseases, 2000, 23(2): 85-88.
4. Song XD, Ren YW, Zhu H, et al. the efficacy of Mycobacterium vaccae on 36 cases of multi-drug resistant pulmonary tuberculosis. Clinical Medicine of China, 2002, 11(18): 1006.
5. Zheng RT, Pan ZW. Clinical observation on therapeutic efficacy of Mycobacterium vaccae in treating the elderly patients with bacterium positive retreated pulmonary tuberculosis, Ningxia Med J, 2005, 27(1): 30-32.
6. Zhou ZH, Shen HL. The clinical analysis of the adjuvant efficacy of Mycobacterium vaccae on recurrent smear-positive pulmonary tuberculosis. China Tropical Medicine, 2005, 5(5): 1009-1010,1015.
7. Shangguan ZX, Zhou JY. The clinical observation on the effect of Mycobacterium vaccae plus chemotherapy on recurrent smear-positive pulmonary tuberculosis. Zhejiang medical Journal, 2005, 3(27): 236-238.
8. Rao PA, Gan XF. The effect of chemotherapy plus Mycobacterium vaccae vaccine in treatment of 30 cases with recurrent pulmonary tuberculosis. Journal of Clinical Pulmonary Medicine, 2005, 5(10): 602.
9. Yao HB, Sang HZ, Guo L, et al. The observation of the effect of the treatment of multi-drug resistant pulmonary tuberculosis with M Vaccae. The Journal of The Chinese Antituberculosis Association, 2005, 6(27): 389-392.
10. Liu YH. The observation of the adjuvant efficacy of Mycobacterium vaccae on multi-drug resistant pulmonary tuberculosis. Chinese Journal of Primary Medicine and Pharmacy, 2006, 3(13): 492-493.
11. Wang JY, Lin DW. The effect of Mycobacterium vaccae on multi-drug resistant pulmonary tuberculosis. Acta Medicinae Sinica, 2006, 3(19): 443-445.
12. Zou LN, Shao YD,Wang RW, et al. The effect of Mycobacterium vaccae on 38 senior cases of recurrent smear-positive pulmonary tuberculosis. Journal of Clinical Pulmonary Medicine, 2006, 3(11): 377-378.
13. Wu GD, Li LH. The effect of Mycobacterium vaccae plus Dipasic on 177 cases with recurrent pulmonary tuberculosis. The Journal of The Chinese Antituberculosis Association, 2006, supplement(28): 32.
14. 孙照平, 刘辉.母牛分枝杆菌菌苗用于结核病防治的研究现状.中国防痨杂志,2006, 28(6): 413-415.
15. World Health Organization. Treatment of tuberculosis: Guidelines for national programmes.WHO/CDS/ TB/ 2003.313. Geneva: WHO, 2003.
16. 卫生部疾病控制司.中国结核病防治规划实施工作指南, 2002. 3.
17. Jüni P, Altman DG, Egger M. Systematic reviews in health care: Assessing the quality of controlled clinical trials. BMJ, 2001, 323: 42–46.
18. Alderson P, Green S, Higgins JPT. Cochrane Reviewers’ Handbook 4.2.2[updated March 2004]. In: The Cochrane Library, Issue 1, 2004.
19. 罗永艾, 卢水华, 郭述良, 等. 母牛分枝杆菌菌苗在难治性肺结核治疗中的作用.中华结核和呼吸杂志, 2000, 23(2): 85-88.
20. 宋小冬, 任彦薇, 朱红, 等. 微卡方案治疗耐多药肺结核36例疗效观察.中国综合临床, 2002, 11(18): 1006.
21. 郑如添, 潘治文. 母牛分枝杆菌菌苗辅助治疗老年复治菌阳肺结核临床观察.宁夏医学杂志, 2005, 27(1): 30-32.
22. 周志红,申红连.母牛分枝杆菌菌苗辅助治疗复治菌阳肺结核的临床分析.中国热带医学,2005,5(5): 1009-1010,1015.
23. 上官宗校,周建英.微卡联合化疗药物治疗复治涂阳肺结核的疗效观察.浙江医学, 2005, 3(27): 236-238.
24. 饶平安,甘先锋.化疗药物联合微卡治疗涂阳复治肺结核30例疗效观察.临床肺科杂志,2005, 5(10): 602.
25. 姚恒波,尚好珍,郭磊,等.微卡辅助治疗耐多药肺结核的临床研究.中国防痨杂志,2005, 6(27): 389-392.
26. 刘月花. 微卡菌苗辅助治疗多种耐药肺结核的疗效观察.中国基层医药, 2006, 3(13): 492-493.
27. 王继业,林定文.母牛分枝杆菌菌苗在耐多药肺结核治疗中的作用.华夏医学, 2006, 3(19): 443-445.
28. 邹良能,邵以德,王人委,等.微卡治疗老年复治涂阳肺结核38例疗效观察.临床肺科杂志, 2006, 3(11): 377-378.
29. 吴高达,李力鸿. 微卡与力克菲蒺合用对177例复治肺结核临床疗效观察.中国防痨杂志, 2006, 增刊(28): 32.
30. Stanford JL, BahR GM, Rook GAM,et al.Immunotherapy with Mycobacterium vaccae as an adjunct to chemotherapy in the treatment of pulmonary tuberculosis.Tubercle,1990,71:87.

Chinese Journal of Evidence-Based Medicine

Adjuvant Effect of Mycobacterium Vaccae on Treatment of Recurrent Treated Pulmonary Tuberculosis: A Meta-analysis

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