Objective:

To evaluate the efficacy and safety of ambroxol hydrochloride and clenbuterol hydrochloride oral solution (AHCHOS) in pediatric patients with wheezing disorders and provide a comprehensive evidence map of the current clinical status, highlighting its significance in clinical practice.

Key Findings:

• 227 RCTs included in evidence mapping; 14 met criteria for meta-analysis.
• Combination therapy with AHCHOS significantly improved overall response rate (RR 1.26, 95% CI 1.10–1.44) and effective rate (RR 1.55, 95% CI 1.36–1.76).
• AHCHOS reduced duration of coughing (MD -1.40 days, 95% CI -1.75 to -1.06), wheezing (MD -1.88 days, 95% CI -2.50 to -1.26), cough phlegm (MD -2.00 days, 95% CI -2.76 to -1.24), wet lung sounds (MD -1.82 days, 95% CI -2.33 to -1.30), pulmonary rales (MD -2.27 days, 95% CI -2.90 to -1.64), and hospital stay (MD -1.13 days, 95% CI -1.45 to -0.82).
• AHCHOS did not increase the risk of adverse events compared to conventional treatment.

Interpretation:

Combination therapy with AHCHOS is associated with modest but statistically significant improvements in symptom resolution and length of hospital stay compared to conventional treatment, suggesting potential benefits for clinical practice.

Limitations:

• All studies conducted in China, limiting generalizability.
• Inconsistent adverse event reporting prevents definitive safety conclusions.
• Potential biases in the included studies may affect the reliability of the findings.

Conclusion:

AHCHOS shows potential benefits in treating pediatric wheezing disorders, but further safety assessments in future trials are warranted to confirm these findings.