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.	孫照平, 劉輝.母牛分枝桿菌菌苗用于結核病防治的研究現狀.中國防癆雜志,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.	衛生部疾病控制司.中國結核病防治規劃實施工作指南, 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.	羅永艾, 盧水華, 郭述良, 等. 母牛分枝桿菌菌苗在難治性肺結核治療中的作用.中華結核和呼吸雜志, 2000, 23(2): 85-88.
20.	宋小冬, 任彥薇, 朱紅, 等. 微卡方案治療耐多藥肺結核36例療效觀察.中國綜合臨床, 2002, 11(18): 1006.
21.	鄭如添, 潘治文. 母牛分枝桿菌菌苗輔助治療老年復治菌陽肺結核臨床觀察.寧夏醫學雜志, 2005, 27(1): 30-32.
22.	周志紅,申紅連.母牛分枝桿菌菌苗輔助治療復治菌陽肺結核的臨床分析.中國熱帶醫學,2005,5(5): 1009-1010,1015.
23.	上官宗校,周建英.微卡聯合化療藥物治療復治涂陽肺結核的療效觀察.浙江醫學, 2005, 3(27): 236-238.
24.	饒平安,甘先鋒.化療藥物聯合微卡治療涂陽復治肺結核30例療效觀察.臨床肺科雜志,2005, 5(10): 602.
25.	姚恒波,尚好珍,郭磊,等.微卡輔助治療耐多藥肺結核的臨床研究.中國防癆雜志,2005, 6(27): 389-392.
26.	劉月花. 微卡菌苗輔助治療多種耐藥肺結核的療效觀察.中國基層醫藥, 2006, 3(13): 492-493.
27.	王繼業,林定文.母牛分枝桿菌菌苗在耐多藥肺結核治療中的作用.華夏醫學, 2006, 3(19): 443-445.
28.	鄒良能,邵以德,王人委,等.微卡治療老年復治涂陽肺結核38例療效觀察.臨床肺科雜志, 2006, 3(11): 377-378.
29.	吳高達,李力鴻. 微卡與力克菲蒺合用對177例復治肺結核臨床療效觀察.中國防癆雜志, 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. 孫照平, 劉輝.母牛分枝桿菌菌苗用于結核病防治的研究現狀.中國防癆雜志,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. 衛生部疾病控制司.中國結核病防治規劃實施工作指南, 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. 羅永艾, 盧水華, 郭述良, 等. 母牛分枝桿菌菌苗在難治性肺結核治療中的作用.中華結核和呼吸雜志, 2000, 23(2): 85-88.
20. 宋小冬, 任彥薇, 朱紅, 等. 微卡方案治療耐多藥肺結核36例療效觀察.中國綜合臨床, 2002, 11(18): 1006.
21. 鄭如添, 潘治文. 母牛分枝桿菌菌苗輔助治療老年復治菌陽肺結核臨床觀察.寧夏醫學雜志, 2005, 27(1): 30-32.
22. 周志紅,申紅連.母牛分枝桿菌菌苗輔助治療復治菌陽肺結核的臨床分析.中國熱帶醫學,2005,5(5): 1009-1010,1015.
23. 上官宗校,周建英.微卡聯合化療藥物治療復治涂陽肺結核的療效觀察.浙江醫學, 2005, 3(27): 236-238.
24. 饒平安,甘先鋒.化療藥物聯合微卡治療涂陽復治肺結核30例療效觀察.臨床肺科雜志,2005, 5(10): 602.
25. 姚恒波,尚好珍,郭磊,等.微卡輔助治療耐多藥肺結核的臨床研究.中國防癆雜志,2005, 6(27): 389-392.
26. 劉月花. 微卡菌苗輔助治療多種耐藥肺結核的療效觀察.中國基層醫藥, 2006, 3(13): 492-493.
27. 王繼業,林定文.母牛分枝桿菌菌苗在耐多藥肺結核治療中的作用.華夏醫學, 2006, 3(19): 443-445.
28. 鄒良能,邵以德,王人委,等.微卡治療老年復治涂陽肺結核38例療效觀察.臨床肺科雜志, 2006, 3(11): 377-378.
29. 吳高達,李力鴻. 微卡與力克菲蒺合用對177例復治肺結核臨床療效觀察.中國防癆雜志, 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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