摘要
目的探讨英夫利昔联合硫唑嘌呤(IFX+AZA)、英夫利昔联合肠内营养(IFX+EN)治疗克罗恩病的相对疗效及安全性。方法由2位评价者独立检索PubMed、Cochrane Library、Embase、Medline、维普(VIP)、万方数据库(Wanfang)、中国知网(CNKI)、中国生物医学文献服务系统(CBM)的相关文献,选择IFX+AZA与IFX+EN比较或IFX+AZA与IFX比较或IFX+EN与IFX比较的前瞻性随机对照试验(RCT)、队列研究或meta分析,选择有效率与不良反应发生率为终点指标,通过间接比较法(ITC)比较IFX+AZA与IFX+EN的相对疗效及安全性。结果共纳入8项研究,其中包括IFX+AZA与IFX比较的RCT 5篇,回顾性研究2篇,IFX+EN与IFX比较的meta分析1篇,克罗恩病患者共计1 461例。IFX+AZA与IFX+EN较IFX对中重度克罗恩病具有更好的疗效,且安全性无明显差异。结论IFX+AZA与IFX+EN治疗克罗恩病的疗效与安全性相当。
Objective To explore the relative efficacy and safety of infliximab combined with azathioprine(IFX+AZA)and infliximab combined with enteral nutrition(IFX+EN)in the treatment of Crohn′s disease.Methods PubMed,Cochrane Library,Embase,Medline,VIP,Wanfang,CNKI and China Biomedical Document Service System(CBM)were retrievaled by two independent reviewers,the prospective randomized controlled clinical trial(RCT),cohort study,or meta-analysis of comparison of enteral nutrition combined with infliximab vs.azathioprine combined with infliximab or infliximab combined with azathioprine vs.infliximab or infliximab combined with enteral nutrition vs.infliximab is selected for this study,selecting efficacy and adverse event rates as endpoints of the study,comparing the relative efficacy and safety between infliximab combined with azathioprine and infliximab combined with enteral nutrition through indirect comparisons.Results A total of 8 studies were included,including 5 RCT and 2 retros pective studies comparing IFX+AZA with IFX,1 meta-analysis of IFX+EN and IFX,and 1 461 Crohn′s disease patients was included.Infliximab combined with azathioprine and infliximab in combination with enteral nutrition had a better efficacy in the treatment of moderate-severe Crohn′s disease and no significant difference in safety when comparing with infliximab.Conclusion IFX+AZA and IFX+EN in the treatment of Crohn′s disease have equal efficacy and safety.
作者
谭小燕
宋镭
姜政
TAN Xiaoyan;SONG Lei;JIANG Zheng(Department of Gastrointestinal,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)
出处
《现代医药卫生》
2019年第19期2973-2977,共5页
Journal of Modern Medicine & Health
关键词
克罗恩病
英夫利昔单抗
硫唑嘌呤
肠内营养
间接比较
Crohn′s disease
Infliximab
Azathioprine
Enteral nutritionin
Indirect comparison
