维生素D作为多发性硬化添加治疗的系统评价

发布时间：2018-03-20 11:17

本文选题：多发性硬化　切入点：维生素D　出处：《中国免疫学杂志》2017年02期 　论文类型：期刊论文

【摘要】：目的:评价维生素D作为添加治疗多发性硬化的有效性与安全性。方法:通过检索Pubmed、EMbase、Cochrane图书馆以及中国知网、万方等电子数据库获取文献,时间为2016年2月截止。使用检索关键词"多发性硬化"、"multiple sclerosis"、"MS"以及药名"维生素D"、"vitamin D""Cholecalciferol"。两名作者独立检索以及提取数据。使用RevM an5.3软件对提取资料进行统计分析。结果:共4个试验247名患者纳入研究。①有效性方面,在12个月时,维生素D在EDSS评分[MD=-0.33,95%Confidence interval(CI)=(-0.68,0.01),P=0.05]、复发率[MD=-0.08,95%CI=(-0.37,0.21),P=0.60]以及钆增强病变的数量[MD=-0.16,95%CI=(-0.57,0.25),P=0.45]与安慰剂无明显差异。但24个月时,维生素D在EDSS评分[MD=-0.48,95%CI=(-0.87,-0.09),P=0.02]和复发率[MD=-0.27,95%CI=(-0.52,-0.02),P=0.03]均优于单一治疗。②安全性方面,各研究均无高钙血症的发生,常见的不良反应有腹泻、发热、便秘、消化不良、头疼等,但均属轻度,停药后可缓解。结论:维生素D作为添加治疗多发性硬化时其临床疾病指标表明与安慰剂无差异,但随着治疗时间的延迟,维生素D优于安慰剂。受纳入研究数量和质量所限,上述结论尚需更大样本量和更长期的研究予以验证。
[Abstract]:Objective: to evaluate the efficacy and safety of vitamin D in the treatment of multiple sclerosis. The time is February 2016. The search keywords "multiple sclerosis", "multiple sclerosis", "MS" and the drug names "vitamin D" and "vitamin D" "Cholecalciferol" are used to retrieve and extract the data independently. The results are analyzed by using RevM an5.3 software. : a total of 247 patients in four trials were included in study .1 in terms of effectiveness, At 12 months, there was no significant difference between the EDSS score (MD-0.3395 CI) of vitamin D and the placebo. However, at 24 months, the vitamin D score [MD-0.0895], the recurrence rate [MD-0.0895CIK] and the number of gadolinium-enhanced lesions [MD-0.1695CI-0.5795 / 0.25P0.45] were superior to those of the placebo. However, at 24 months, the EDSS score [MD-0.48CI-0.871-0.09P0.02] and the recurrence rate [MD-0.27095 CI-20.5-0.02P0.03] were superior to those of the placebo. There was no hypercalcinemia in all the studies. The common adverse reactions were diarrhea, fever, constipation, indigestion, headache, etc. Conclusion: there is no difference between vitamin D and placebo, but with the delay of treatment, vitamin D is superior to placebo.Conclusion: vitamin D is limited by the quantity and quality of the study. These conclusions need to be verified by larger sample size and longer-term studies.
【作者单位】：兰州大学第二医院神经内科;
【分类号】：R744.51

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