糠酸氟替卡松治疗支气管哮喘疗效及安全性的系统评价

发布时间：2018-04-17 05:15

本文选题：糠酸氟替卡松 + 哮喘　；参考：《中国循证医学杂志》2017年01期

【摘要】：目的系统评价糠酸氟替卡松治疗支气管哮喘的疗效及安全性。方法计算机检索The Cochrane Library(2016年2期)、Pub Med、CNKI、VIP、Wan Fang Data等数据库,搜集糠酸氟替卡松治疗支气管哮喘的随机对照试验(RCT),检索时间均为建库至2016年2月。由2位评价者按照纳入与排除标准独立筛选文献、提取资料并评价偏倚风险后,采用Rev Man 5.3软件进行统计分析。结果共纳入6个RCT,包括4 383例患者。Meta分析结果显示:(1)糠酸氟替卡松vs.安慰剂:糠酸氟替卡松不仅能显著增加一秒用力呼气量谷值[MD=0.10,95%CI(0.05,0.15),P=0.000 2],且能改善24小时无需使用缓解药物率和24小时无症状率,而不增加治疗相关不良反应发生率[OR=1.38,95%CI(0.28,6.77),P=0.69];(2)糠酸氟替卡松vs.糠酸氟替卡松+维兰特罗:糠酸氟替卡松+维兰特罗可显著增加一秒用力呼气量谷值[MD= 0.10,95%CI( 0.19, 0.01),P=0.02],且可改善0~24小时加权平均一秒用力呼气量、24小时无需使用缓解药物率及24小时无症状率,不增加治疗相关不良反应发生率[OR= 1.05,95%CI( 1.39, 0.80),P=0.72];(3)糠酸氟替卡松vs.丙酸氟替卡松:二者的一秒用力呼气量谷值[MD= 0.02,95%CI( 0.08,0.04),P=0.52]、24小时无需使用缓解药物率及治疗相关不良反应发生率[OR=1.62,95%CI(0.77,3.40),P=0.20]均无显著差异。结论糠酸氟替卡松较安慰剂可显著改善患者肺功能,控制哮喘症状;糠酸氟替卡松与维兰特罗联用比单用糠酸氟替卡松疗效更好,且不增加不良反应发生率;糠酸氟替卡松与丙酸氟替卡松两者疗效相当,但用法更简便,能很大程度上提高患者的依从性。受纳入研究数量和质量所限,上述结论可能存在偏倚,需开展更多高质量研究予以验证。
[Abstract]:Objective to evaluate the efficacy and safety of fluticasone furoate in the treatment of bronchial asthma.Methods the The Cochrane Library database was searched by computer. The data were collected from a randomized controlled trial of fluticasone furoate in the treatment of bronchial asthma. The retrieval time of the database was established until February 2016.According to the inclusion and exclusion criteria, the two evaluators independently sifted the literature, extracted the data and evaluated the bias risk, and then used Rev Man 5.3 software to carry out statistical analysis.Results A total of 6 RCTs were included, including 4 383 patients. Meta-analysis showed that: 1) fluticasone furoate vs.Placebo: fluticasone furoate not only significantly increased the forced expiratory volume (FVV) of one second [MD0.1095CI0. 05 ~ 0. 15], but also improved the remission rate and asymptomatic rate for 24 hours without increasing the incidence of adverse reactions associated with treatment [OR1.3895CI0.286.77 P0. 69] Fluticasone furoate vs.Fluticasone verantrol furoate: fluticasone furoate significantly increased the forced expiratory volume by one second [MD= 0.10 ~ 95 CI (0.19, 0.01) P0. 02], and improved the weighted average forced expiratory volume of 0 ~ 24 hours per second for 24 hours without the need for a remission drug.Rate and 24 hour asymptomatic rate,The incidence of adverse reactions associated with treatment was not increased [OR = 1.05% 95 CI (1.39, 0.80% P0. 72]) fluticasone furoate vs3).Fluticasone propionate: there was no significant difference in the second forced expiratory volume valley value (MD = 0.02 卤95) between the two groups (0. 08% 0. 04% P0. 52) and 24 hours no need for remission drug use and the incidence of adverse events associated with treatment [OR1. 6295CII = 0. 77- 3. 40P0. 20].Conclusion Fluticasone furoate can significantly improve pulmonary function and control asthma symptoms compared with placebo the combination of fluticasone furoate and veranbuterol has better efficacy than fluticasone furoate alone and does not increase the incidence of adverse reactions.The efficacy of fluticasone furoate and fluticasone propionate is similar, but it is easier to use and can improve the compliance of patients to a great extent.Limited by the quantity and quality of the studies, these conclusions may be biased and need to be verified by more high-quality studies.
【作者单位】：重庆医科大学附属永川医院呼吸内科;
【分类号】：R562.25

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