摘要
目的:评价沙美特罗替卡松联合孟鲁司特治疗咳嗽变异性哮喘的疗效和安全性,为临床提供循证参考。方法:计算机检索Cochrane图书馆、Pub Med、中国期刊全文数据库、中文科技期刊数据库、万方数据库,纳入沙美特罗替卡松联合孟鲁司特(试验组)对比沙美特罗替卡松(对照组)治疗咳嗽变异性哮喘疗效(总有效率和显效率、咳嗽消失时间、6~12个月复发率)与安全性(不良反应发生率)的随机对照试验(RCT),提取资料并采用Cochrane系统评价手册5.1.0进行质量评价后,采用Rev Man 5.3软件进行Meta分析。结果:共纳入10项RCT,合计976例患者。Meta分析结果显示,试验组患者总有效率[RR=1.22,95%CI(1.16,1.29),P<0.001]、显效率[RR=1.38,95%CI(1.22,1.56),P<0.001]显著高于对照组,咳嗽消失时间显著短于对照组[MD=-3.07,95%CI(-3.54,-2.59),P<0.001],6~12个月复发率显著低于对照组[RR=0.24,95%CI(0.11,0.54),P<0.001],以上差异均有统计学意义;两组患者不良反应发生率比较差异无统计学意义[RR=1.58,95%CI(0.99,2.51),P=0.05]。结论:沙美特罗替卡松联合孟鲁司特对比沙美特罗替卡松单用治疗咳嗽变异性哮喘疗效更好,但联合用药时应注意不良事件的发生。
OBJECTIVE:To evaluate the efficacy and safety of salmeterol/fluticasone combined with montelukast versus salmeterol/fluticasone in the treatment of cough variant asthma,and to provide reference for evidence-based reference in clinic.METHODS:Retrieved from Cochrane library,PubMed,Chinese Journal Full-text Database,VIP and Wanfang database,randomized controlled trials(RCTs)about therapeutic efficacy(total response rate,marked improvement rate,cough disappearance time,6-12 months recurrence rate)and safety(the incidence of ADR)of salmeterol/fluticasone combined with montelukast(trial group)vs.salmeterol/fluticasone(control group)in the treatment of cough variant asthma were included.Meta-analysis was performed by using Rev Man 5.3 software after data extraction and quality evaluation with Cochrane system evaluation manual 5.1.0.RESULTS:Totally 10 RCTs were included,involving 976 patients.Results of Meta-analysis showed the total response rate[RR=1.22,95%CI(1.16,1.29),P<0.001]and marked improvement rate[RR=1.38,95%CI(1.22,1.56),P<0.001]of trial group were significantly higher than those of control group;the cough disappearance time was significantly shorter than control group[MD=-3.07,95%CI(-3.54,-2.59),P<0.001],and 6-12 months recurrence rate was significantly lower than control group[RR=0.24,95%CI(0.11,0.54),P<0.001],with statistical significance.There was no statistical significance in the incidence of ADR between 2 groups[RR=1.58,95%CI(0.99,2.51),P=0.05].CONCLUSIONS:The salmeterol/fluticasone combined with montelukast is better than of salmeterol/fluticasone in the treatment of cough variant asthma,but great importance should be attached to the occurrence of adverse events when using drug combination.
作者
冯文涛
易红
袁浩宇
FENG Wentao;YI Hong;YUAN Haoyu(Dept.of Pharmacy,Sichuan Provincial Fifth People’s Hospital,Chengdu 610031,China;Dept.of Pharmacy,No.416 Hospital of Nucleus Industry/the Second Affiliated Hospital of Chengdu Medical College,Chengdu 610051,China)
出处
《中国药房》
CAS
北大核心
2018年第5期699-703,共5页
China Pharmacy
基金
四川省卫生和计划生育委员会课题(No.120058)
