大剂量应用维生素C治疗相关疾病安全性的系统评价  

Systematic Review on the Safety of Large Dose of Vitamin C Treatment for Related Diseases

作　　者：许婧[1,2] 刘京铭[1,2] 付雷[1,2] 王彬[1,2] 赵伟杰[1,2] 王慧琳[1,2] 高孟秋[1,2] 

机构地区：[1]北京市结核病胸部肿瘤研究所 [2]首都医科大学附属北京胸科医院,北京101149

出　　处：《中国药房》2015年第9期1229-1233,共5页China Pharmacy

摘　　要：目的:系统评价大剂量应用维生素C治疗相关疾病的安全性,以为临床用药提供循证参考。方法:计算机检索Cochrane图书馆、EMBase、Pub Med、中国期刊全文数据库、万方数据库、中文科技期刊数据库,收集大剂量应用维生素C治疗相关疾病的临床研究,提取资料并评价质量后,采用R语言3.1.1版统计软件对数据进行Meta分析。结果:共纳入23项研究,合计2 069例患者,共发生不良反应540例。Meta分析结果显示,针对有对照组的研究,维生素C治疗组患者总体不良反应发生率与对照组比较差异无统计学意义[RR=1.42,95%CI(0.92,2.20),P=0.382];针对所有纳入研究,维生素C治疗组患者的腹痛发生率为9%[95%CI(0.05,0.14)]、口干发生率为30%[95%CI(0.14,0.54)]、头痛发生率为12%[95%CI(0.06,0.25)]、恶心发生率为25%[95%CI(0.13,0.44)]、腹泻发生率为14%[95%CI(0.07,0.26)]。结论:大剂量应用维生素C治疗相关疾病的安全性较好,但应注意消化系统的不良反应。由于缺乏大样本随机对照试验(RCT)资料,且随访时间较短,该结论尚需要更多大样本、多中心的RCT予以证实。OBJECTIVE：To systematically evaluate the safety of large dose of vitamin C（VC）treatment for related diseases and provide reference for the rational use of drug in clinic. METHODS：Cochrone Library,EMbase,Pub Med,CJFD,Wan Fang database and VIP were retrieved for collecting clinical trials with large dose of VC. A Meta-analysis was conducted by using R 3.1.1software after quality extraction and data evaluation. RESULTS：There were 23 clinical trials including 2 069 patients,540 patients with adverse reactions. Meta-analysis showed there were significant differences in the total incidence of adverse reactions between VC group and control group [RR=1.42,95%CI（0.92,2.20）,P=0.382];for all included studies,the incidence of stomachache in VC group was 9% [95% CI（0.05,0.14）],incidence of thirst was 30% [95% CI（0.14,0.54）],the incidence of headache was 12%[95%CI（0.06,0.25）],the incidence of nausea was 25%[95%CI（0.13,0.44）],the incidence of diarrhea was 14%[95%CI（0.07,0.26）]. CONCLUSIONS：Large dose of VC treatment has good safety,but the adverse reactions related to the digestive system should be noted. Due to the lack of large-scale randomized controlled trials（RCT）data and the short follow-up time,the conclusion needs to be verified with more large-sample and multiple-center RCT.

关 键 词：大剂量 维生素C 系统评价 安全性 

分 类 号：R151.3[医药卫生—营养与食品卫生学]