不同剂型利福平对比治疗肺结核疗效和安全性的Meta分析  

Meta-analysis of the Efficacy and Safety of Different Dosage Forms of Rifampicin in the Treatment of Tuberculosis

作　　者：陈爽[1] 杨海鹏[1] 陈娟[1] 郭蕊[1] 罗琳[1] 

机构地区：[1]河南省胸科医院药剂科,郑州450000

出　　处：《中国药房》2015年第15期2097-2099,共3页China Pharmacy

基　　金：国家科技支撑计划课题(No.2013BAI06B04)

摘　　要：目的:系统评价不同剂型利福平对比治疗肺结核的疗效和安全性,以为临床治疗提供循证参考。方法:计算机检索Ovid-medline、Pub Med、EMBase、Cochrane图书馆、中国期刊全文数据库、中文科技期刊数据库、万方数据库和相关网站,收集利福平注射液(试验组)对比利福平胶囊/片剂(对照组)治疗肺结核的随机对照试验(RCT),提取资料并进行质量评价后,采用Rev Man 5.2统计软件进行Meta分析。结果:共纳入18项RCT,合计1 646例患者。Meta分析结果显示,试验组患者痰菌转阴率[初治RR=1.20,95%CI(1.12,1.27),P<0.000;复治RR=1.23,95%CI(1.04,1.46),P=0.02;继发RR=1.23,95%CI(1.12,1.34),P<0.000]和病灶吸收率[初治RR=1.18,95%CI(1.10,1.26),P<0.000;复治RR=1.37,95%CI(1.03,1.82),P=0.03;继发RR=1.20,95%CI(1.11,1.31),P<0.000]均显著优于对照组,两组比较差异均有统计学意义;两组患者肝功能异常发生率比较差异无统计学意义[RR=0.98,95%CI(0.78,1.23),P=0.86]。结论:利福平注射液治疗初治、复治、继发性肺结核的疗效显著优于口服剂型,安全性相当。由于纳入研究质量一般,该结论有待大样本、高质量的RCT进一步验证。OBJECTIVE：To systematically review the efficacy and safety of different dosage forms of rifampicin in the treatment of tuberculosis and provide evidence-based reference for the clinical treatment.METHODS：The Ovid-medline,Pub Med,EMBase,Cochrane Library,CJFD and VIP database were retrieved to collect the RCT of Rifampicin injection（test group）versus Rifampicin capsules/tablets（control group） in the treatment of tuberculosis.After the information collection and quality evaluation,Rev Man 5.2 software was used for Meta-analysis.RESULTS：There were totally 18 RCT,including 1 646 patients.Meta analysis showed that,the sputum negative conversion rates of experimental group [primary tuberculosis with RR=1.20,95%CI（1.12,1.27）,P〈0.000;recurrent tuberculosis with RR=1.23,95%CI（1.04,1.46）,P=0.02;secondary tuberculosis with RR=1.23,95%CI（1.12,1.34）,P〈0.000] and the lesions absorption rates[primary tuberculosis with RR=1.18,95%CI（1.10,1.26）,P〈0.000;recurrent tuberculosis with RR=1.37,95%CI（1.03,1.82）,P=0.03;secondary tuberculosis with RR=1.20,95%CI（1.11,1.31）,P〈0.000] were significantly better than the control group,there were significant differences between two groups;there were no differences on the impact of liver function[RR=0.98,95%CI（0.78,1.23）,P=0.86].CONCLUSIONS：Rifampicin injection was better than oral rifampicin in the treatment of primary,recurrent and secondary tuberculosis.There was no difference for security of the two groups.Due to the low-quality of included studies,it remains to be further verified with large-sample and high-quality RCT.

关 键 词：利福平注射液 口服利福平 肺结核 META分析 疗效 安全性 

分 类 号：R521[医药卫生—内科学]