吡非尼酮对特发性肺纤维化疗效的Meta分析

发布时间：2018-10-13 09:33

【摘要】：目的系统评价吡非尼酮对特发性肺纤维化(IPF)的疗效和安全性。方法计算机检索在Pub Med、Cochrane图书馆、相关期刊论文(CNKI)、中国生物医学文献数据库(CBM)、万方数据库、中文科技期刊全文数据库(VIP)发表的以吡非尼酮为干预措施治疗IPF的随机对照试验。按Cochrane系统评价方法,评价纳入研究的方法学质量并提取有效数据,采用Rev Man 5.2进行Meta分析。结果最终纳入6篇文献,合计1 727例。Meta分析结果显示,与安慰剂对照组比较,吡非尼酮能提高治疗前后肺活量变化率[WMD=0.06,95%CI(0.01,0.12),Z=2.48,P=0.01;异质性检验χ~2=1.03,P=0.31];不能提高治疗前后6分钟步行试验中最低氧分压变化率[WMD=0.82,95%CI(-1.35,2.98),Z=0.74,P=0.46;异质性检验χ~2=8.90,P=0.003];不能降低病死率[RR=0.62,95%CI(0.37,1.03),Z=1.85,P=0.06;异质性检验χ~2=3.05,P=0.55]。吡非尼酮组光敏性、头晕等主要不良反应发生率明显高于对照组(P0.05),关节痛不良反应发生率与对照组比较差异无统计学意义(P0.05)。结论由于纳入文献数量较少且存在设计和报道数据的缺陷,目前尚不能评价吡非尼酮的远期疗效和安全性,现有的临床试验证据不足以支持吡非尼酮成为IPF的治疗用药。
[Abstract]:Objective to evaluate the efficacy and safety of pifenidone in the treatment of idiopathic pulmonary fibrosis (IPF). Methods computer search was carried out in Pub Med,Cochrane Library, full text Database of Chinese Journals, (CNKI), Database of Chinese Biomedical Literature, (CBM), Wanfang Database. Chinese Journal of Science and Technology full-text database (VIP) published a randomized controlled trial with pifenidone as an intervention in the treatment of IPF. According to the evaluation method of Cochrane system, the quality of methodology included in the study was evaluated and valid data were extracted. Meta analysis was carried out with Rev Man 5.2. Results A total of 1 727 cases were included in 6 articles. The results of Meta analysis showed that compared with placebo control group, 鍚￠潪灏奸叜鑳芥彁楂樻不鐤楀墠鍚庤偤娲婚噺鍙樺寲鐜嘯WMD=0.06,95%CI(0.01,0.12),Z=2.48,P=0.01;寮傝川鎬ф楠屜噡2=1.03,P=0.31];涓嶈兘鎻愰珮娌荤枟鍓嶅悗6鍒嗛挓姝ヨ璇曢獙涓渶浣庢哀鍒嗗帇鍙樺寲鐜嘯WMD=0.82,95%CI(-1.35,2.98),Z=0.74,P=0.46;寮傝川鎬ф楠屜噡2=8.90,P=0.003];涓嶈兘闄嶄綆鐥呮鐜嘯RR=0.62,95%CI(0.37,1.03),Z=1.85,P=0.06;寮傝川鎬ф楠屜噡2=3.05,P=0.55]. The incidence of major adverse reactions such as Guang Min dizziness and so on was significantly higher in pifenidone group than that in control group (P0.05) while the incidence of joint pain was not significantly different from that in control group (P0.05). Conclusion due to the limited number of literatures and the defects of design and report data, it is not possible to evaluate the long-term efficacy and safety of pifenidone at present. The available clinical trial evidence is not sufficient to support the use of pifenidone as a therapeutic drug for IPF.
【作者单位】：甘肃省人民医院呼吸科;甘肃中医学院临床学院;兰州大学第二临床医学院;兰州大学第一临床医学院;兰州大学第二附属医院呼吸科;
【分类号】：R563

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