福莫特罗治疗支气管哮喘的Meta分析  

Meta analysis of formoterol in the treatment of asthma

作　　者：刘秀书[1] 曹艳[1] 杜岚[1] 邹爱英[1] 

机构地区：[1]天津中医药大学第二附属医院,天津300150

出　　处：《天津药学》2015年第3期27-32,共6页Tianjin Pharmacy

基　　金："十二五"国家科技支撑计划课题(No.2013BA106B04)

摘　　要：目的:评价福莫特罗与其他β2受体激动剂治疗支气管哮喘的临床疗效和安全性。方法:计算机检索Cochrane图书馆、Pub Med数据库、Medline(Ovid)and MEDLINE In-Process&Other-数据库、Embase(Ovid)数据库、中国期刊全文数据库(CNKI)、中文科技期刊全文数据库(维普)和万方数字化期刊全文库,纳入福莫特罗对比其他β2受体激动剂沙美特罗、沙丁胺醇和特布他林,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3项RCT和3项SR文献。Meta分析结果显示:1急性发作需要住院的概率:与沙美特罗和特布他林相比,福莫特罗改善哮喘发作需要住院的概率无统计学差异;2急性发作需要口服糖皮质激素的概率:与沙美特罗和沙丁胺醇相比,福莫特罗改善发作需要口服糖皮质激素的概率无统计学差异;3肺功能:与沙丁胺醇相比,呼气流量峰值(PEF)和第1秒用力呼气量(FEV1)的变化值均有统计学差异[WMD=47.56,95%CI(28.68,66.44),P<0.000 01]和[WMD=0.35,95%CI(0.23,0.47),P<0.000 01],表明福莫特罗对肺功能的改善更为明显;与特布他林相比,PEF的变化值无统计学差异;4不良反应发生率:与其他三种β2受体激动剂相比,差异均无统计学意义。结论:福莫特罗与另外3种β2受体激动剂相比,除福莫特罗较沙丁胺醇可显著改善肺功能外,其余在改善肺功能、导致哮喘恶化和引起不良反应方面没有差异。Objective： To evaluate the efficacy and safety of fomoterol and other beta 2 agonists in the treatment of asthma. Method： Cochrane library, Pubmed database, Medline （Ovid） and MEDLINE In - Process ＆ Other database, Embase（Ovid） da- tabase, CNKI database, VIP database and Wanfang database were searched. Randomized controlled trials （RCT） and systematic review （SR） of formoterol versus other beta 2 agonists such as salmeterol, salbutamol and terbutaline in asthma were selected, then quality evaluation and Meta - analysis were performed. The conclusions of SR included were taken into consideration. Re- suits ： There were 3 RCTs and 3 SRs in according with the inclusion criteria. When it comes to patients with an exacerbation requi- ting hospitalization, there were no significant differences between formoterol and salmeterol or terbutaline. There were also no sig- nificant differences between formoterol and salmeterol or salbutamol in patients with an exacerbation requiring oral corticosteroids. PEF and FEV1 of formoterol were better than salbutamol [ WMD =47.56, 95% CI（28. 68, 66. 44）, P 〈0. 00001 ] and [ WMD = 0. 35, 95% C1（0. 23, 0. 47 ）,P 〈 0.00001 ] , which showed that formoterot was more effective in improving lung function. There were no significant differences among four beta 2 agonists in total adverse events. Conclusion ： There were no significant differences in lung function, patients with an exacerbation requiring hospitalization or oral corticosteroids and total adverse events except that formoterol was more effective in improving lung function than salbutamol.

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：R974[医药卫生—药品]