摘要
目的利用现有的文献评价沙利度胺治疗克罗恩病的疗效与安全性,为临床治疗提供参考依据。方法利用计算机检索关于沙利度胺治疗克罗恩的相关文献,严格按照纳入排除标准进行文献筛选后进行系统性评价。结果最终符合纳入标准的研究共18项,患者总数为381例。Meta分析结果显示:临床缓解的合并RR=0.88,95%CI 0.53~1.48,合并率为46.8%,95%CI 34.6%~59.6%;实现激素减量的合并RR=1.97,95%CI 0.55~7.09,其合并率66.3%,95%CI 35.4%~87.6%;生物制剂治疗失败后取得临床缓解的合并RR=1.72,95%CI 0.88~3.36,其总体率为63.2%,95%CI46.8%~77.1%;实现瘘管闭合的合并RR=0.69,95%CI 0.38~1.26,其总体率为41%,95%CI 27.5%~55.8%;实现黏膜愈合的合并RR=0.50,95%CI 0.23~1.11,其总体率为33%,95%CI 18.7%~52.6%。一共有64.5%的患者发生了不良反应,其中25.2%的患者因不良反应而停药。结论沙利度胺治疗克罗恩病有一定疗效,但使用时需注意其不良反应。
Objective To conduct a systematic review to assess the efficacy and safety of thalidomide in crohn disease. Methods Using a computer system to retrieve the related literature with thalidomide treating Corhn disease, according to the strict into exclusion criteria for literature after screening, and systematic evaluation. Results A total of 18 studies met the inclusion criteria, with a total of 381 patients. The results of Meta-analysis showed: the RR of clinical remission was 0.88(95% CI 0.53-1.48), the combined rate was 46.8%(95% CI 34.6%-59.6%). The RR of steroid reduction was 1.97(95% CI 0.55-7.09), the combined rate was 66.3%(95% CI 35.4%-87.6%). The RR of the clinical remission after biological therapy failure was 1.72(95% CI 0.88-3.36), the combined rate was 63.2%(95% CI 46.8%-77.1%). The RR of fistula closure was 0.69(95% CI 0.38-1.26), the combined rate was 41%(95% CI 27.5%-55.8%). The RR of mucosal healing overall rate was 0.50(95% CI 0.23-1.11), the combined rate was 33%(95% CI 18.7%-52.%). A total of 64.5% of patients had adverse reactions, of which 25.2% of patients discontinued due to adverse reactions. Conclusion Thalidomide treatment of Crohn disease has a certain effect, however, attention should be paid to its adverse reactions when using.
出处
《中华临床医师杂志（电子版）》
CAS
2017年第7期1153-1157,共5页
Chinese Journal of Clinicians(Electronic Edition)
关键词
克罗恩病
沙利度胺
临床缓解
不良反应
系统评价
】 Crohn disease
Thalidomide
Clinical remission
Adverse reaction
Systematic review
