摘要
目的系统评价依那西普联合甲氨蝶呤与单用甲氨蝶呤比较治疗类风湿关节炎的有效性和安全性。方法计算机检索Web of Science、Medline、Embase、Cochrane图书馆、中国生物医学文献数据库、维普数据库、中国期刊全文数据库、万方数据库,检索时限均从建库起截止2015年12月,根据Cochrane系统评价方法对纳入的随机对照试验进行方法学质量评价,并用Rev Man 5.3软件进行Meta分析。结果共纳入9个随机对照试验,1005例患者。Meta分析结果显示,依那西普联合甲氨蝶呤组在总有效率、美国风湿病学会RA缓解标准ACR20、ACR50、ACR70、C反应蛋白(CRP)、红细胞沉降率(ESR)、类风湿因子(RF)、关节压痛数(DAS28)、休息痛(VAS)、药品不良反应(ADR)等方面疗效均优于甲氨蝶呤组,且差异有统计学意义(P<0.05);在ACR-N AUC和ADR发生率方面,两组差异无统计学意义(P>0.05)。结论依那西普联合甲氨蝶呤疗效优于单用甲氨蝶呤,但纳入试验质量较低,该结论还需高质量、大样本研究进一步验证。
Objective Systematic evaluation on efficacy and safety of treatment in rheumatoid arthritis withetanercept and methotrexate compared with methotrexate alone. Methods Searches of Web of Science,Medline Embase,Cochrane Library,CBM, VIP,CJFDandWan Fang Database were all updated to Dec. 2015. Randomized controlled trials included were evaluated in methodological quality according to the Cochrane systematic evaluation method with RevMan 5. 3 software for Meta analysis. Results Nine randomized controlled trials,1005 patients were included. Meta analysis results showed that,the curative effect of etanercept combined with methotrexate was superior to methotrexate alone group in the total effective rate,American College of Rheumatology RA remission ACR20,ACR50,ACR70,c-reactive protein（CRP）,erythrocyte sedimentation rate（ESR）,rheumatoid factor（RF）,tender joint count（DAS28）,rest pain（VAS）,adverse drug reactions（ADR）,etc. The difference was statistically significant（P〈0. 05）;In terms of ACR-N AUC and the incidence of ADR,the differences between the two groups had no statistical significance（ P〉0. 05）. Conclusion The curative effect of etanercept combined with methotrexate is superior to methotrexate alone,but the quality of tests included is low,the conclusion also need high quality,large sample research for further validation.
出处
《四川医学》
CAS
2016年第10期1144-1148,共5页
Sichuan Medical Journal
