A systematic review of the efficacy and safety of the immunomodulator thymic polypeptides as adjuvant treatment for severe pneumonia

JIANG Ziyun; ZHANG Yangyang; YANG Huilin; ZHOU Jianguo; LI Xun

doi:10.16462/j.cnki.zhjbkz.2024.05.017

Volume 28 Issue 5

May 2024

Turn off MathJax

Article Contents

Article Navigation > CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION > 2024 > 28(5): 596-606

JIANG Ziyun, ZHANG Yangyang, YANG Huilin, ZHOU Jianguo, LI Xun. A systematic review of the efficacy and safety of the immunomodulator thymic polypeptides as adjuvant treatment for severe pneumonia[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(5): 596-606. doi: 10.16462/j.cnki.zhjbkz.2024.05.017

Citation:

JIANG Ziyun, ZHANG Yangyang, YANG Huilin, ZHOU Jianguo, LI Xun. A systematic review of the efficacy and safety of the immunomodulator thymic polypeptides as adjuvant treatment for severe pneumonia[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(5): 596-606. doi: 10.16462/j.cnki.zhjbkz.2024.05.017

Citation:

JIANG Ziyun, ZHANG Yangyang, YANG Huilin, ZHOU Jianguo, LI Xun. A systematic review of the efficacy and safety of the immunomodulator thymic polypeptides as adjuvant treatment for severe pneumonia[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(5): 596-606. doi: 10.16462/j.cnki.zhjbkz.2024.05.017

PDF( 4494 KB)

A systematic review of the efficacy and safety of the immunomodulator thymic polypeptides as adjuvant treatment for severe pneumonia

doi: 10.16462/j.cnki.zhjbkz.2024.05.017

1.
Department of Management, Beijing University of Chinese Medicine, Beijing 100029, China
2.
The Second Clinical Medicine College, Beijing University of Chinese medicine, Beijing 100078, China
3.
Fangshan Hospital of Beijing University of Chinese Medicine, Beijing 102488, China
4.
Beijing Econ Medical Technology Co, Beijing 100062, China
5.
Center for Evidence Based Medicine, Beijing University of Chinese Medicine, Beijing 100029, China

Funds:

Major Program "Modernization of traditional Chinese Medicine" of The National Major Research and Development Plan of China 2022YFC3501400

Fundamental Research Funds for Beijing University of Chinese Medicine 2022-JYB-JBRW-013

Education Research Program of Beijing University of Chinese Medicine XJY22020

More Information

Corresponding author: LI Xun, E-mail: tina000341@163.com
Received Date: 2023-06-29
Rev Recd Date: 2023-12-04

Available Online: 2024-06-05

Publish Date: 2024-05-10

Abstract

Abstract

Objective To evaluate the effectiveness and safety for thymic polypeptides as adjunctive treatment of severe pneumonia and explore the rationality for application. Methods A systematic searching was conducted in six Chinese and English databases to identify randomized controlled trials on the use of thymic polypeptides for severe pneumonia. After screening, the included studies were subjected to quality assessment and data synthesis. Results A total of 28 randomized controlled trials involving 2 228 participants were included. Results showed that the thymic polypeptide group had lower mortality rate (RR=0.51, 95% CI: 0.32-0.83, P=0.006), higher effectiveness rate (RR=1.24, 95% CI: 1.19-1.30, P < 0.001), shorter ICU stay (MD=-3.03, 95% CI: -3.79--2.26, P < 0.001), shorter mechanical ventilation time (MD=-61.34, 95% CI: -65.55--57.12, P < 0.001), and better blood gas and inflammatory indicators compared to the control group, with no significant difference in adverse event rate (P > 0.05). Subgroup analyses revealed a trend for reduced ICU stay for patients over 60. The quality of evidence was generally low, with high heterogeneity in some indicators. Conclusions Based on the available evidence, thymic polypeptides show certain advantages as adjuvant treatment for severe pneumonia. However, there are limitations in the current evidence that do not justify the widespread use of them in China, There is a need for more RCTs to be conducted in the future, along with in-depth research into the safety and economic benefits of these medications.
- Severe pneumonia,
- Thymosin,
- Thymopentin,
- Systematic review,
- Immunomodulatory

FullText(HTML)

References(43)

References

[1]	中国医师协会急诊医师分会. 中国急诊重症肺炎临床实践专家共识[J]. 中国急救医学, 2016, 36(2): 97-107. DOI: 10.3969/j.issn.1002-1949.2016.02.001. Emergency Medical Doctor Branch of the Chinese Medical Doctor Association. Expert consensus on clinical practice of emergency severe pneumonia in China[J]. Chin J Critical Care Med, 2016, 36(2): 97-107. DOI: 10.3969/j.issn.1002-1949.2016.02.001.
[2]	Nair GB, Niederman MS. Updates on community acquired pneumonia management in the ICU[J]. Pharmacol Ther, 2021, 217: 107663. DOI: 10.1016/j.pharmthera.2020.107663.
[3]	Ferreira-Coimbra J, Sarda C, Rello J. Burden of community-acquired pneumonia and unmet clinical needs[J]. Adv Ther, 2020, 37(4): 1302-1318. DOI: 10.1007/s12325-020-01248-7.
[4]	Morton B, Pennington SH, Gordon SB. Immunomodulatory adjuvant therapy in severe community-acquired pneumonia[J]. Expert Rev Respir Med, 2014, 8(5): 587-596. DOI: 10.1586/17476348.2014.927736.
[5]	翁剑真, 李燕明. 重症肺炎免疫调节治疗: 正反两面[J]. 中国实用内科杂志, 2022, 42(3): 191-195. DOI: 10.19538/j.nk2022030104. Weng JZ, Li YM. Immunomodulatory therapy for severe pneumonia: two sides to every coin[J]. Chin J Pract Intern Med, 2022, 42(3): 191-195. DOI: 10.19538/j.nk2022030104.
[6]	刘秀珍, 刘建军, 李俊峰. 胸腺肽类药物在脓毒症患者中的应用研究进展[J]. 中国药业, 2022, 31(7): 124-127. DOI: 10.3969/j.issn.1006-4931.2022.07.032. Liu XZ, Liu JJ, Li JF. Research progress of thymic polypeptides in patients with sepsis[J]. China Pharm, 2022, 31(7): 124-127. DOI: 10.3969/j.issn.1006-4931.2022.07.032.
[7]	Bellet MM, Renga G, Pariano M, et al. COVID-19 and beyond: Reassessing the role of thymosin alpha1 in lung infections[J]. Int Immunopharmacol, 2023, 117: 109949. DOI: 10.1016/j.intimp.2023.109949.
[8]	马晓华, 康建, 张晓坚, 等. 运用循证医学方法建立胸腺法新合理用药评价标准[J]. 中国医院药学杂志, 2017, 37(3): 273-277. DOI: 10.13286/j.cnki.chinhosppharmacyj.2017.03.16. Ma XH, Kang J, Zhang XJ, et al. Establishment of evidence-based criteria to evaluate the new rational use of thymalfasin[J]. Chin J Hosp Pharm, 2017, 37(3): 273-277. DOI: 10.13286/j.cnki.chinhosppharmacyj.2017.03.16.
[9]	蒋理添, 王昊德, 郑义, 等. 胸腺肽类药物用于预防或治疗新型冠状病毒肺炎的可能性: 基于既往冠状病毒预防和治疗的总结[J]. 医学与社会, 2020, 33(5): 42-47. DOI: 10.13723/j.yxysh.2020.05.009. Jiang LT, Wang HD, Zheng Y, et al. Evaluation of the possibility of thymosin for COVID-19 prevention and treatment: based on the summary of previous coronavirus prevention and treatment[J]. Mediche and Society, 2020, 33(5): 42-47. DOI: 10.13723/j.yxysh.2020.05.009.
[10]	Matteucci C, Minutolo A, Balestrieri E, et al. Thymosin alpha 1 mitigates cytokine storm in blood cells from coronavirus disease 2019 patients[J]. Open Forum Infect Dis, 2020, 8(1): ofaa588. DOI: 10.1093/ofid/ofaa588.
[11]	南宇飞. 胸腺肽治疗老年重症肺炎有效性的Meta分析[J]. 中国当代医药, 2015, 22(36): 4-6, 10. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGUD201536002.htm Nan YF. Meta analysis of effective that thymosin in treating elderly severe pneumonia[J]. Chin Mod Med, 2015, 22(36): 4-6, 10. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGUD201536002.htm
[12]	陆媛, 蒋卫民, 张斌, 等. α1胸腺肽辅助治疗老年重症医院获得性肺炎疗效的Meta分析[J]. 江苏医药, 2014, 40(19): 2304-2307. DOI: 10.19460/j.cnki.0253-3685.2014.19.023. Lu Y, Jiang WM, Zhang B, et al. A Meta analysis on efficacy of thymosin α1 in treating elderly patients with severe hospital-acquired pneumonia[J]. Jiangsu Med J, 2014, 40(19): 2304-2307. DOI: 10.19460/j.cnki.0253-3685.2014.19.023.
[13]	杨崇艳. 头孢哌酮/舒巴坦联合胸腺肽α1治疗鲍曼不动杆菌重症肺炎的临床应用分析[J]. 中国全科医学, 2019, 22(S2): 115-117. https://www.cnki.com.cn/Article/CJFDTOTAL-QKYX2019S2041.htm Yang CY. Clinical application of cefoperazone/sulbactam combined with thymosin α1 in the treatment of severe pneumonia caused by Acinetobacter baumannii[J]. Chin Gen Pract, 2019, 22(S2): 115-117. https://www.cnki.com.cn/Article/CJFDTOTAL-QKYX2019S2041.htm
[14]	卢经伟, 刘君君. 胸腺肽α1辅助治疗老年重症肺炎的疗效观察[J]. 西南军医, 2014, 16(3): 286-287. DOI: 10.3969/j.issn.1672-7193.2014.03.020. Lu JW, Liu JJ. Observation on the curative effect of thymosin α1 in adjuvant treatment of severe pneumonia in the elderly[J]. J Mil Surg Southwest Chin, 2014, 16(3): 286-287. DOI: 10.3969/j.issn.1672-7193.2014.03.020.
[15]	朱倩. 胸腺肽α1免疫治疗对老年重症肺炎患者免疫功能及炎性因子水平的影响[J]. 现代医学与健康研究电子杂志, 2020, 4(19): 27-29. https://www.cnki.com.cn/Article/CJFDTOTAL-XYJD202019013.htm Zhu Q. Effect of thymosin α1 immunotherapy on immune function and inflammatory factors in elderly patients with severe pneumonia[J]. Modern Medicine and Health Research E, 2020, 4(19): 27-29. https://www.cnki.com.cn/Article/CJFDTOTAL-XYJD202019013.htm
[16]	李瑞书. 免疫治疗对重症肺炎患者免疫功能指标的影响研究[J]. 中国卫生标准管理, 2017, 8(19): 82-84. DOI: 10.3969/j.issn.1674-9316.2017.19.041. Li RS. Effect of immunotherapy on immune function indexes in patients with severe pneumonia[J]. Chin Health Standard Management, 2017, 8(19): 82-84. DOI: 10.3969/j.issn.1674-9316.2017.19.041.
[17]	胡男彬. 胸腺肽α1用于重症肺炎治疗中的疗效分析[J]. 家庭医药, 2016, (12): 65. DOI: 10.3969/j.issn.1671-4954.2016.12.061. Hu NB. Curative effect analysis of thymosin α1 in the treatment of severe pneumonia[J]. lfome Medicine, 2016, (12): 65. DOI: 10.3969/j.issn.1671-4954.2016.12.061.
[18]	李莉, 吴芬, 沈红卫. 胸腺肽α联合哌拉西林他唑巴坦治疗重症肺炎的疗效观察及对患者血浆降钙素原、超敏C反应蛋白和可溶性血管内皮生长因子受体1变化的影响[J]. 中国基层医药, 2020, 27(19): 2365-2369. DOI: 10.3760/cma.j.issn.1008-6706.2020.19.014. Li L, Wu F, Shen HW. Effect of thymosin α combined with piperacillin tazobactam compound on severe pneumonia and its influence on the changes of plasma PCT, hs CRP and sFTL-1[J]. Chin J Prim Med Pharm, 2020, 27(19): 2365-2369. DOI: 10.3760/cma.j.issn.1008-6706.2020.19.014.
[19]	季明霞, 斯小水, 何建新, 等. 胸腺肽α1用于重症肺炎治疗的效果观察[J]. 浙江医学, 2015, 37(9): 738-740. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJYE201509012.htm Ji MX, Si XS, He JX, et al. Efficacy of thymosin-α1 for patients with severe pneumonia[J]. Zhejiang Med J, 2015, 37(9): 738-740. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJYE201509012.htm
[20]	古柠华. 头孢哌酮/舒巴坦联合胸腺肽α1治疗鲍曼不动杆菌重症肺炎的临床疗效及预后评估分析[J]. 临床研究, 2020, 28(9): 111-113. https://www.cnki.com.cn/Article/CJFDTOTAL-LCYN202009059.htm Gu NH. Clinical efficacy and prognosis evaluation of cefoperazone/sulbactam combined with thymosin α1 in the treatment of severe pneumonia caused by Acinetobacter baumannii[J]. Clinnical Research, 2020, 28(9): 111-113. https://www.cnki.com.cn/Article/CJFDTOTAL-LCYN202009059.htm
[21]	何新华, 李春盛, 张海燕, 等. 胸腺肽α1对重症社区获得性肺炎的治疗作用[J]. 中华全科医师杂志, 2009, 8(6): 373-376. DOI: 10.3760/cma.j.issn.1671-7368.2009.06.007. He XH, Li CS, Zhang HY, et al. Effectiveness of thymosin alpha-1 on patients with severe community-acquired pneumonia[J]. Chin J Gen Pract, 2009, 8(6): 373-376. DOI: 10.3760/cma.j.issn.1671-7368.2009.06.007.
[22]	郭镕杰, 蔡玲玲, 杨淑贞. 胸腺法新联合头孢哌酮舒巴坦钠对重症肺炎患者炎性因子水平及免疫功能的影响[J]. 医学理论与实践, 2021, 34(24): 4272-4274. DOI: 10.19381/j.issn.1001-7585.2021.24.019. Guo RJ, Cai LL, Yang SZ. Effect of thymosin combined with cefoperazone sulbactam sodium on inflammatory factors and immune function in patients with severe pneumonia[J]. J Med Theor Prac, 2021, 34(24): 4272-4274. DOI: 10.19381/j.issn.1001-7585.2021.24.019.
[23]	肖辉. 胸腺肽α1治疗老年2型糖尿病合并重症肺炎患者的效果及对免疫功能的影响观察[J]. 糖尿病天地, 2018, 15(3): 182. DOI: 10.3969/j.issn.1672-7851.2018.03.155. Xiao H. Effect of thymosin α1 on elderly patients with type 2 diabetes complicated with severe pneumonia and its influence on immune function[J]. Clinial Journal of Diabetes World, 2018, 15(3): 182. DOI: 10.3969/j.issn.1672-7851.2018.03.155.
[24]	刘传文, 杨国青, 高阳辉. 胸腺肽α1免疫治疗在老年重症肺炎中的应用效果[J]. 临床医学, 2019, 39(10): 69-70. DOI: 10.19528/j.issn.1003-3548.2019.10.030. Liu CW, Yang GQ, Gao YH. Effect of thymosin α1 immunotherapy in elderly patients with severe pneumonia[J]. Clinnical Medicine, 2019, 39(10): 69-70. DOI: 10.19528/j.issn.1003-3548.2019.10.030.
[25]	石小软. 免疫治疗对重症肺炎病人免疫功能指标表达的影响[J]. 泰山医学院学报, 2018, 39(3): 336-337. DOI: 10.3969/j.issn.1004-7115.2018.03.037. Shi XR. Effect of immunotherapy on the expression of immune function indexes in patients with severe pneumonia[J]. Journal of Taishan Medical College, 2018, 39(3): 336-337. DOI: 10.3969/j.issn.1004-7115.2018.03.037.
[26]	于磊, 李臻. 胸腺肽α1联合头孢哌酮—舒巴坦钠治疗对泛耐药鲍曼不动杆菌感染重症肺炎患者的效果分析[J]. 医学理论与实践, 2023, 36(13): 2211-2213. DOI: 10.19381/j.issn.1001-7585.2023.13.016. Yu L, Li Z. Effect of thymosin α1 combined with cefoperazone-sulbactam sodium in the treatment of patients with severe pneumonia infected by pan-drug resistant Acinetobacter baumannii[J]. J Med Theory Pract, 2023, 36(13): 2211-2213. DOI: 10.19381/j.issn.1001-7585.2023.13.016.
[27]	岳红云, 韩京旭, 李世元, 等. 胸腺法新联合经鼻高流量湿化氧疗治疗重症肺炎合并呼吸衰竭的效果[J]. 中国医学创新, 2023, 20(16): 27-30. DOI: 10.3969/j.issn.1674-4985.2023.16.007. Yue HY, Han JX, Li SY, et al. Effect of thymalfasin combined with high-flow nasal Cannula oxygen therapy in the treatment of severe pneumonia complicated with respiratory failure[J]. Medical Innovation of China, 2023, 20(16): 27-30. DOI: 10.3969/j.issn.1674-4985.2023.16.007.
[28]	张辉, 陈培莉. 胸腺肽注射液联合利奈唑胺对重症肺炎患者APACHEⅡ评分及免疫功能的影响[J]. 临床研究, 2019, 27(9): 57-58. https://www.cnki.com.cn/Article/CJFDTOTAL-LCYN201909028.htm Zhang H, Chen PL. Effect of thymosin injection combined with linezolid on APACHE Ⅱ score and immune function in patients with severe pneumonia[J]. Clinnical Research, 2019, 27(9): 57-58. https://www.cnki.com.cn/Article/CJFDTOTAL-LCYN201909028.htm
[29]	刘辉, 王运, 甘文云, 等. 胸腺肽辅助比阿培南对老年重症肺炎患者肺功能的影响[J]. 实用中西医结合临床, 2021, 21(19): 14-16. DOI: 10.13638/j.issn.1671-4040.2021.19.006. Liu H, Wang Y, Gan WY, et al. Effect of thymosin assisted biapenem on lung function in elderly patients with severe pneumonia[J]. Pract Clin J Integr Tradit Chin West Med, 2021, 21(19): 14-16. DOI: 10.13638/j.issn.1671-4040.2021.19.006.
[30]	朱海亮. 免疫调节治疗对老年重症肺炎患者免疫功能及临床疗效的影响[D]. 太原: 山西医科大学, 2020. DOI: 10.27288/d.cnki.gsxyu.2020.001059. Zhu HL. Effect of immunomodulatory therapy on immune function and clinical efficacy in elderly patients with severe pneumonia[D]. Taiyuan: Shanxi Medical University, 2020. DOI: 10.27288/d.cnki.gsxyu.2020.001059.
[31]	郑细优, 肖静, 刘翔. 胸腺肽对于重症肺炎合并脓毒血症的疗效观察[J]. 当代医学, 2016, 22(35): 176-177. DOI: 10.3969/j.issn.1009-4393.2016.35.115. Zheng XY, Xiao J, Liu X. Therapeutic effect of thymosin on severe pneumonia complicated with sepsis[J]. Contemp Med, 2016, 22(35): 176-177. DOI: 10.3969/j.issn.1009-4393.2016.35.115.
[32]	熊锋, 朱志德, 刘文德. 胸腺肽治疗重症肺炎合并脓毒血症的临床疗效观察[J]. 安徽医药, 2015, 19(6): 1184-1186. DOI: 10.3969/j.issn.1009-6469.2015.06.055. Xiong F, Zhu ZD, Liu WD. Clinical observation of thymosin in the treatment of severe pneumonia complicated with sepsis[J]. Anhui Medical and Pharmaceutical Journal, 2015, 19(6): 1184-1186. DOI: 10.3969/j.issn.1009-6469.2015.06.055.
[33]	申强. 胸腺肽治疗重症肺炎合并脓毒血症的临床疗效探讨[J]. 中外医疗, 2015, 34(33): 108-109. DOI: 10.16662/j.cnki.1674-0742.2015.33.108. Shen Q. Observation on the clinical effect of thymosin in treatment of severe pneumonia complicated with sepsis[J]. China and Foreign Medical Treatment, 2015, 34(33): 108-109. DOI: 10.16662/j.cnki.1674-0742.2015.33.108.
[34]	谢敏崇, 杜剑文. 胸腺肽治疗重症肺炎合并脓毒血症的临床疗效分析[J]. 中国继续医学教育, 2019, 11(12): 124-126. DOI: 10.3969/j.issn.1674-9308.2019.12.053. Xie MC, Du JW. Clinical efficacy of thymosin in the treatment of severe pneumonia complicated with sepsis[J]. China Continuing Medical Education, 2019, 11(12): 124-126. DOI: 10.3969/j.issn.1674-9308.2019.12.053.
[35]	林攻平. 胸腺肽治疗重症肺炎合并脓毒血症的临床研究[J]. 中外医疗, 2018, 37(19): 127-128, 132. DOI: 10.16662/j.cnki.1674-0742.2018.19.127. Lin GP. Clinical study of thymosin in the treatment of severe pneumonia combined with sepsis[J]. China and Foreign Medical Treatment, 2018, 37(19): 127-128, 132. DOI: 10.16662/j.cnki.1674-0742.2018.19.127.
[36]	王娜. 胸腺五肽对老年患者重症呼吸机相关性肺炎的细胞免疫功能影响[J]. 中国医学前沿杂志(电子版), 2014, 6(11): 41-43. DOI: 10.3969/j.issn.1674-7372.2014.11.017. Wang N. Immune effects of peptide thymosin five elderly patients with severe ventilator-associated pneumonia cells[J]. Chinese Journal of Frontiers of Medical Science (Electronic Version), 2014, 6(11): 41-43. DOI: 10.3969/j.issn.1674-7372.2014.11.017.
[37]	孙睿甜. 胸腺五肽治疗重症肺炎合并脓毒血症的临床疗效及对血清因子的影响[J]. 现代药物与临床, 2021, 36(5): 1013-1017. DOI: 10.7501/j.issn.1674-5515.2021.05.031. Sun RT. Clinical efficacy of thymopentin in treatment of severe pneumonia complicated with sepsis and its effect on serum factors[J]. Drugs and Clinic, 2021, 36(5): 1013-1017. DOI: 10.7501/j.issn.1674-5515.2021.05.031.
[38]	王薇, 田蓉, 王真, 等. 胸腺五肽辅助比阿培南对老年重症肺炎患者肺功能及血清SP-A及SP-D水平的影响[J]. 中国老年学杂志, 2020, 40(18): 3874-3877. DOI: 10.3969/j.issn.1005-9202.2020.18.022. Wang W, Tian R, Wang Z, et al. Effects of thymopentin assisted biapenem on lung function and serum SP-A and SP-D levels in elderly patients with severe pneumonia[J]. Chin J Gerontol, 2020, 40(18): 3874-3877. DOI: 10.3969/j.issn.1005-9202.2020.18.022.
[39]	陈珊珊, 刘芳芳, 刘自双, 等. 胸腺五肽治疗晚期胃癌合并重症肺炎患者的疗效观察[J]. 肿瘤药学, 2019, 9(1): 56-59. DOI: 10.3969/j.issn.2095-1264.2019.01.11. Chen SS, Liu FF, Liu ZS, et al. Therapeutic effects of thymopentin on advanced gastric cancer patients combined with severe pneumonia[J]. Anti Tumor Pharmacy, 2019, 9(1): 56-59. DOI: 10.3969/j.issn.2095-1264.2019.01.11.
[40]	吴薇. 胸腺五肽治疗重症肺炎合并脓毒血症的临床效果观察[J]. 医药前沿, 2022, 12(25): 22-24. Wu W. Clinical effect of Thymopentin in the treatment of severe pneumonia complicated with sepsis[J]. Journal of Frontiers of Medicine, 2022, 12(25): 22-24.
[41]	Shang WF, Zhang B, Ren YL, et al. Thymosin alpha1 use in adult COVID-19 patients: a systematic review and meta-analysis on clinical outcomes[J]. Int Immunopharmacol, 2023, 114: 109584. DOI: 10.1016/j.intimp.2022.109584.
[42]	陈蓉. 胸腺肽注射剂127例不良反应分析[J]. 中国医院药学杂志, 2008, 28(8): 680-681. DOI: 10.3321/j.issn:1001-5213.2008.08.039. Chen R. Analysis of 127 cases of adverse reactions of thymosin injection[J]. Chin J Hosp Pharm, 2008, 28(8): 680-681. DOI: 10.3321/j.issn:1001-5213.2008.08.039.
[43]	刘静, 陈开杰, 贾毅敏. 长江流域273家样本医院2014年药物使用分析[J]. 中国药房, 2016, 27(26): 3617-3620. DOI: 10.6039/j.issn.1001-0408.2016.26.05. Liu J, Chen KJ, Jia YM. Analysis of drug use in 273 sample hospitals of Yangtze River basin in 2014[J]. China Pharmacy, 2016, 27(26): 3617-3620. DOI: 10.6039/j.issn.1001-0408.2016.26.05.