胸腺五肽辅助治疗慢性阻塞性肺疾病临床有效性及安全性的Meta分析

发布时间：2018-11-01 17:03

【摘要】：目的:采用Meta分析方法对胸腺五肽辅助治疗慢性阻塞性肺疾病(COPD)的临床疗效及安全性进行评价,为临床应用及辅助用药管理提供循证参考。方法:计算机检索PubMed、Embase、Cochrane Library、相关期刊论文(CNKI)、万方数据库、维普数据库(VIP)、中国生物医学文献数据库(各数据库检索时间均从建库至2016年1月),收集胸腺五肽辅助治疗COPD的随机对照试验。由2名研究者按照纳入与排除标准独立筛选试验、提取资料、评价方法学质量,采用RevMan 5.3软件进行统计分析。结果:共纳入16项研究,对研究进行合并分析,结果显示,胸腺五肽辅助治疗COPD,有效性高于常规治疗组[RR=1.18,95%CI(1.05,1.32),P=0.004],可使患者FEV1得到显著改善[SMD=0.64,95%CI(0.20,1.09),P=0.005],使患者外周血CD4+水平[WMD=6.25,95%CI(3.02,9.48),P=0.000 1]及CD8+水平显著降低[WMD=-4.60,95%CI(-7.26,-1.94),P=0.000 7],CD4+/CD8+水平显著升高[WMD=0.42,95%CI(0.24,0.59),P0.000 01]。结论:基于现有临床证据,胸腺五肽辅助治疗COPD具有一定临床疗效,但由于纳入研究证据强度较低,存在一定的偏倚风险,本研究结论尚需设计严格的临床对照试验进一步验证。
[Abstract]:Objective: to evaluate the efficacy and safety of thymopeptide in adjuvant treatment of chronic obstructive pulmonary disease (COPD) by means of Meta analysis, and to provide evidence-based reference for clinical application and administration of adjuvant drugs. Methods: PubMed,Embase,Cochrane Library, Chinese periodical full-text database, (CNKI), Wanfang database, and Weip database, (VIP), Chinese biomedical literature database, were searched by computer. The retrieval time of each database was from the establishment of the database to January 2016. A randomized controlled trial of thymopeptide adjuvant therapy for COPD was collected. According to the criteria of inclusion and exclusion, two researchers were selected independently to extract the data and evaluate the quality of methodology. The statistical analysis was carried out with RevMan 5.3 software. Results: the combined analysis of 16 studies showed that the efficacy of thymopeptide adjuvant therapy in COPD, was higher than that in routine treatment group [RR=1.18,95%CI (1.051.32), P0. 004]. FEV1 was significantly improved [SMD=0.64,95%CI (0.20 卤1.09), P < 0.005] and CD4 level in peripheral blood [WMD=6.25,95%CI (3.02 卤9.48)]. The levels of CD8 and CD4 / CD8 were significantly decreased [WMD=-4.60,95%CI (-7.261-1.94), P0. 000 7] and CD4 / CD8 increased significantly [WMD=0.42,95%CI (0.240.59), P0.00001]. Conclusion: based on the available clinical evidence, thymopeptide adjuvant therapy for COPD has a certain clinical efficacy, but due to the low intensity of evidence included in the study, there is a certain risk of bias. The conclusion of this study needs to be further verified by a strict clinical controlled trial.
【作者单位】：黄石市第二医院药剂科;华中科技大学同济医学院附属协和医院药剂科;首都医科大学附属北京友谊医院药学部;
【基金】：湖北省自然科学基金项目(编号:2015CFB225)
【分类号】：R563.9

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