布病抗生素治疗的Meta分析

发布时间：2018-06-20 07:13

本文选题：布病 + 抗生素　；参考：《中国免疫学杂志》2017年05期

【摘要】：目的:系统评价目前最常用布病疗法的有效性和安全性。方法:检索Pub Med和Cochrane协作网的CENTRAL数据库中1985年至今全部有关布病治疗的英文文献以及CBM数据库中所有有关布病的中文随机对照试验。使用Cochrane协作网推荐的随机对照实验偏倚风险评估工具评估纳入研究质量。使用固定效应模型M-H法合并和分析不同抗生素组合治疗布病的复发率,总体治疗失败率和不良反应率。结果:共纳入随机对照实验17篇。比较了DR、DS、QR、DG等抗生素联合治疗方案。DS治疗方案总体治疗失败率(RR_(合并):2.53,95%CI:1.51~4.23)和复发率(RR_(合并):2.69,95%CI:1.46~4.98)低于DR方案,不良反应率二者无显著差别(RR_(合并):1.40,95%CI:0.97~2.01);QR组和DR组的复发率(RR_(合并):1.24,95%CI:0.67~2.30)和总体治疗失败率(RR_(合并):1.41,95%CI:0.86~2.32)并无显著差异。不良反应方面,QR组低于DR组(RR_(合并):1.79,95%CI:1.17~2.74)。结论:DS治疗方案治疗布病优于DR;QR组与DR组疗效相差无几,但QR方案不良反应更少;双抗治疗的基础上再增加一种抗生素可以提高治疗效果,不良反应率没有明显升高,但仍需更多临床证据证明。
[Abstract]:Objective: to evaluate the efficacy and safety of the most commonly used brucellosis therapy. Methods: all the English literature on brucellosis treatment in the CENTral database of Pub Med and Cochrane collaboration and all the Chinese randomized controlled trials on brucellosis in CBM database were searched. A randomized controlled trial bias risk assessment tool recommended by Cochrane collaboration was used to assess the quality of the study. The fixed effect model (M-H) was used to combine and analyze the recurrence rate, the overall failure rate and the adverse reaction rate of different antibiotic combinations in the treatment of brucellosis. Results: a total of 17 randomized controlled trials were conducted. The overall treatment failure rate and the overall treatment failure rate of the DS regimen were compared with that of the Dr scheme. The overall failure rate and the relapse rate were lower than that of the Dr scheme, which were compared with those of the DRDDS QRG regimen. The overall failure rate of the DS regimen was lower than that of the Dr scheme, and the overall treatment failure rate and the relapse rate were lower than that of the Dr scheme. There was no significant difference in the adverse reaction rate between the two groups. There was no significant difference between the two groups. There was no significant difference between the two groups. There was no significant difference between the two groups. There was no significant difference between the two groups. There was no significant difference between the two groups. There was no significant difference between the two groups. There was no significant difference between the two groups. There was no significant difference between the two groups. There was no significant difference between the two groups. Adverse reactions were lower in QR group than in Dr group. Conclusion the therapeutic effect of the fraction DS regimen on brucellosis is similar to that of the DRQR group, but the adverse reactions of QR regimen are less, and the addition of an antibiotic on the basis of double antibody therapy can improve the therapeutic effect, but the adverse reaction rate is not significantly increased. But more clinical evidence is needed.
【作者单位】：内蒙古医科大学自治区分子生物学重点实验室;
【基金】：国家“十二五”科技支撑计划项目(2014BAI13B03) 国家自然科学基金(81660272、81460248、81260457) 内蒙古自治区科技重大专项内蒙古自治区自然科学基金(2016MS0318、2016MS0368、2015MS0820、2013MS1138、2012MS1121) 内蒙古自治区科技计划(20120101、20120402、20110501) 内蒙古自治区卫计委医疗卫生科研计划项目(201301035、2010018) 内蒙古自治区高等学校科学研究项目(NJZY109) 内蒙古医科大学青年创新基金项目(YKD2013QNCX012)资助
【分类号】：R516.7

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