福莫特罗或布地奈德福莫特罗治疗支气管哮喘的Meta分析  

Meta-Analysis of Formoterol or Budesonide Formoterol in the Treatment of Asthma

作　　者：刘秀书[1] 杜岚[1] 邹爱英[1] 曹艳[1] 

机构地区：[1]天津中医药大学第二附属医院,天津300150

出　　处：《中国药学杂志》2015年第5期454-459,共6页Chinese Pharmaceutical Journal

基　　金："十二五"国家科技支撑计划课题资助项目(2013BAI06B04)

摘　　要：目的评价福莫特罗治疗支气管哮喘的临床疗效和安全性。方法计算机检索中英文数据库,纳入加或不加布地奈德,福莫特罗对比安慰剂治疗支气管哮喘的随机对照试验(RCT)和系统评价(SR)文献,对纳入的随机对照试验进行方法学质量评价和Meta分析,并参考现有的质量评价和Meta分析结论。结果纳入符合入选标准的7项随机对照试验和6项系统评价文献。Meta分析结果显示:1福莫特罗对比安慰剂:福莫特罗可显著增加哮喘急性发作需要住院的概率,其余二者均无显著差异;2布地奈德福莫特罗对比布地奈德:布地奈德福莫特罗可显著改善哮喘患者的呼气流量峰值(PEF)和第一秒用力呼气量(FEV1),同时显著增加哮喘儿童急性发作需要住院的概率,当布地奈德使用常规剂量时还会显著增加哮喘患者急性发作需要口服糖皮质激素的概率,但二者的不良反应无显著差异。结论本研究结果显示,单独使用福莫特罗治疗哮喘有弊无利,因此不推荐单独应用;福莫特罗联合布地奈德,尤其是联合低剂量的布地奈德,不仅能减少哮喘发作,提高患者的生活质量,而且还能改善肺功能,是一种相对安全的治疗方法。OBJECTIVE To evaluate the efficacy and safety of formoterol in the treatment of asthma. METHODS Chinese and English databases were searched. Randomized controlled trims （RCT） and systematic review （SR） of formoterol versus pla- cebo with or without budesonide in asthma were selected, then quality evaluation and meta-analysis were performed. The conclu- sions of SR included were taken into consideration. RESULTS There were 7 RCTs and 6 SRs in according with the inclusion criteria. Comparing with placebo, formoterol would increase the number of patients with an exacerbation requiring hospitalization more obviously, and there were no significant differences on other indices. PEF and FEV1 of bndesonide formoterol were better than budesonide. However, budesonide formoterol increased the number of children with an exacerbation requiring hospitalization more obviously. When the common dose of bndesonide was used, the number of patients with an exacerbation requiring oral corti- costeroids in budesonide formoterol group was more than that in budesonide group. There were no significant differences between two groups in total adverse events. CONCLUSION The results showed that it had everything to lose and nothing to gain when formoterol was used alone. Therefore, it is not recommended to use formoterol alone. Formoterol plus budesonide, especially the lower dose of budesonide, is a safe treatment method relatively, which would not only decrease asthma attack and improve the quality of life but also improve lung function.

关 键 词：福莫特罗 支气管哮喘 META分析 随机对照试验 系统评价 

分 类 号：R969.1[医药卫生—药理学]