氨氯地平和硝苯地平治疗高血压的临床有效性与安全性的Meta分析  

Efficacy and Safety of Amlodipine and Nifedipine in Clinical Treatment of Hypertension: Meta-Analysis

作　　者：张庆业[1] 涂星[1,2] 范丽霞[1] 罗骞[1] 苏芬丽[1] 熊芬[1] 孙旭[1] 

机构地区：[1]广州中医药大学第一附属医院,广东广州510405 [2]广州中医药大学,广东广州510405

出　　处：《今日药学》2014年第12期882-886,共5页Pharmacy Today

基　　金：广东省医院药学研究基金(编号:2014A12);广东省临床用药研究基金(编号:2013X64)

摘　　要：目的探讨氨氯地平和硝苯地平治疗高血压的有效性和安全性的差异,为临床用药提供参考。方法计算机检索中国知网、维普数据库和万方数据库,收集1990-2014年间国内公开发表的关于氨氯地平和硝苯地平治疗高血压的相关文献,以高血压患者为研究人群,干预措施为单用氨氯地平或单用硝苯地平,临床疗效结局指标为疾病控制率,安全性结局指标为头痛、心动过速和水肿的发生率。应用Review Manager5.2进行数据分析,并分别以优势比（odds ratio,OR）及各自的95%可信区间作为效应指标进行比较。结果共筛选出15篇文献,氨氯地平及苯磺酸氨氯地平的临床疗效显著优于硝苯地平,但与硝苯地平的缓释制剂或控释制剂无显著差异;出现头痛头晕、心动过速、下肢水肿和皮肤潮红不良反应发生率总体数据的OR分别为0.33[0.19,0.50],0.17[0.07,0.45],0.38[0.23,0.62]和0.50[0.30,0.83],且P〈0.05,即氨氯地平治疗高血压出现头痛头晕、心动过速、下肢水肿和皮肤潮红不良反应低于硝苯地平。结论与硝苯地平相比,氨氯地平及苯磺酸氨氯地平临床治疗高血压更有效、更安全;硝苯地平缓控释制剂的临床疗效优于硝苯地平。Objective To investigate the efficacy and safety of amlodipine and nifedipine in the clinical treatment of hypertension,so as to provide reference for their clinical application. Methods The literatures related to clinical treatment on hypertension by amlodipine and nifedipine published in China were collected by computer-based retrieval from CNKI,VIP information network and Wanfang database. The total effective rate was used as the clinical efficacy index,and incidence rate of headache and dizziness,edema of lower extremity,pyknocardia and erubescence were used as the safety index. And the Meta-analysis of clinical data in the included literatures was performed by Review Manger 5. 2 software.Results A total of 15 literatures were included. Clinical curative effect ofamlodipine besylate tablet and amlodipine was significantly higher than nifedipine, but there was no significant differences between nifedipine sustained release preparation or controlled release preparations with amlodipine besylate tablet or amlodipine. The odds ratio of over all efficacy data from amlodipine group and nifedipine groupwere 2. 85[1. 95,4. 14 ],P〈0. 05,indicating that the total efficacy in amlodipine group was significantly higher than that in nifedipine group. The odds ratioand 95% CI of headache and dizziness,edema of lower extremity,pyknocardia and erubescencefromamlodipine group and nifedipine group were0. 33[0. 19,0. 50],0. 17[0. 07,0. 45 ],0. 38[0. 23,0. 62] and 0. 50[0. 30,0. 83 ],P〈0. 05,indicating that the total incidence of adverse reactions in amlodipine group was significantly lower than that in nifedipine group. Conclusion Compared with nifedipine,amlodipine and amlodipine besylate tablet are more effective and safe in the clinical treatment of hypertension. Clinical curative effect of nifedipine sustained release preparation or controlled release preparations was better than nifedipine.

关 键 词：硝苯地平 氨氯地平 高血压 有效性和安全性 META分析 

分 类 号：R97[医药卫生—药品]