摘要
目的系统评价地氯雷他定治疗荨麻疹的疗效和安全性。方法以地氯雷他定(或地洛他定)和荨麻疹为检索词,通过万方,CNKI,维普(VIP),中国生物医学文献数据库(SinoMed),Cochrane Library,PubMed,Medline,EMbase数据库,检索从2000年1月到2018年6月地氯雷他定对比其他抗组胺药物治疗荨麻疹相关临床试验,并手工检索相关杂志。文献筛选、质量评价、数据提取、纳入研究的偏倚风险评估等工作均由2名独立研究者进行。采用RevMan5.3软件进行Meta分析。结果通过文献筛选和质量评价,共纳入47项临床试验,包含4972例患者(试验组2449例,对照组2523例),汇总分析结果提示地氯雷他定疗效优于其他抗组胺药物(RR=1.06,95%CI=1.03~1.09,P=0.0003),并且不良事件发生率相对较低(OR=0.70,95%CI=0.58~0.85,P=0.0003)。亚组分析提示地氯雷他定相对氯雷他定(RR=1.05,95%CI=1.00~1.10,P=0.04)、咪唑斯汀(RR=1.10,95%CI=1.03~1.16,P=0.002)和西替利嗪(RR=1.07,95%CI=1.02~1.13,P=0.008)疗效较好。结论相较于其他抗组胺药物,地氯雷他定治疗荨麻疹疗效较好,并且安全性较为可靠,属于高效、长效抗菌消炎药物,适合临床广泛开展。
Objective To evaluate the efficacy and safety of desloratadine in the patients with chronic urticarial (cu). Methods WanFang Data,CNKI,VIP,Cochrane Library,PubMed,Medline and EMbase database from January,2000 to June,2018were searched to collect case-control studies about the association between desloratadine and other antihistamine medicine.Relevant journals and conference proceedings were also manuallysearched.Two reviewers independently screened literature,evaluated quality,extracted data and assessed the risk of bias of included studies.Then,Meta-analysis was conducted using RevMan 5.0 software. Results A total of 47 trials involving 4 972 participants contributed to the meta analysis.The results of the meta-analysis indicated that desloratadine showed better effect on the improvement of signs and symptoms compared with other antihistamine medicine( RR = 1.06 ,95% CI = 1.03 ~ 1.09 ,P = 0.0003 ).Further subgroup analysis showed that efficacy of dicloretadine is inspecially better than chloretadine( RR = 1.05 ,95% CI = 1.00 - 1.10 ,P = 0.04 ),mizuositing( RR = 1.10 ,95% CI = 1.03 - 1.16 ,P = 0.002 ) and siltiriazine( RR = 1.07 ,95% CI = 1.02 - 1.13 ,P = 0.008 ).At the same time,desloratadine was safer than other antihistamine medicine( OR = 0.73 ,95% CI = 0.60 - 0.90 ,P = 0.003 ). Conclusion Desloratadine has more advantages in the treatment of chronic urticaria,and the safety is relatively reliable.It is an efficient and long-lasting drug.which makes it very suitable for extensive clinical application.
作者
郎罡
温海燕
母立峰
宋金春
Lang Gang;Wen Haiyan;Mu Lifeng;Song Jinchun(Shenzhen China Resources Gosun Pharmaceutical Co.,Shenzhen 518049,China;Department of Pharmacy,Renmin Hospital of Wuhan University,Wuhan 430060,China)
出处
《临床荟萃》
CAS
2019年第8期752-758,共7页
Clinical Focus
