特比萘芬与伊曲康唑治疗趾甲真菌病复发率Meta分析  

Meta-analysis of the Mycological Recurrences of Toenail Onychomycosis after Successful Treatment with Terbinafine Versus Itraconazole

作　　者：王素环[1] 宋维芳[2] 于宇[2] 林炳基[2] 

机构地区：[1]安徽医科大学解放军174临床学院皮肤科,福建厦门361003 [2]厦门大学附属成功医院(解放军第174医院)皮肤科,福建厦门361003

出　　处：《中国皮肤性病学杂志》2015年第12期1240-1243,共4页The Chinese Journal of Dermatovenereology

摘　　要：目的系统评价特比萘芬与伊曲康唑治疗趾甲真菌病的复发率。方法计算机检索Cochrane图书馆，PubMed，EMBASE，CBMdisc，CNKI和万方数据库，搜索特比萘芬与伊曲康唑治疗趾甲真菌病的真菌学复发率的临床随机对照试验（RCTs），治疗组采用特比萘芬治疗，对照组采用伊曲康唑治疗。检索时间截至2014年5月。由两名研究者共同独立提取资料并评估纳入研究质量。采用Stata9．0软件对试验数据进行统计分析。结果两个亚组共纳入7篇文章包括11个RCT，共包括347例患者，治疗组216例，对照组131例。高质量文章1篇。亚组一即短期（随访时间≤1年）的真菌学复发率包括4个RCT；亚组二即长期（随访时间〉1年）的真菌学复发率包括7个RCT。Meta分析结果显示，特比萘芬与伊曲康唑治疗趾甲真菌病的真菌学复发率的差异有统计学意义，亚组-RR＊=0．33，95％C10．15～0．73，亚组二RR：0．51，95％C10．37～0．72。结论现有临床证据表明，特比萘芬治疗趾甲真菌病真菌学治愈后的真菌学复发率低于伊曲康唑，但临床应用的确切疗效尚需更多的RCT证实。Objective To evaluate the mycological recurrences of toenail onychomycosis after successful treatment with terbinafine versus itraconazole. Methods Data were collected from the Coehrane Library, Pubmed, EM- BASE, CBMdisc, CNKI and WANFANG using the term ＂randomized controlled trials （RCTs） comparing the mycological recurrences of toenail onychomycosis after successful treatment with terbinafine and itraeon- azole＂ ,date up to the end of May 2014. Data were extracted and evaluated by two reviewers independently. The statistical analysis was conducted using Stata 9.0 software. Results A total of eleven RCTs of seven papers ineluding 347 patients （216 in treated and 131 in control group） were included in the Meta-analy- sis. Methodological quality evaluation showed one high quality paper. Sub-group one included 4 RCTs, which compared the short-term mycological recurrences （ follow-up time 〈 one year） of toenail onyehomycosis after successful treatment with terbinafine versus itraconazole, while 7 RCTs in sub-group two compared the long- term mycological recurrences （ follow-up time 〉 1 year）. The respective Meta-analysis showed significant difference in mycological recurrences of toenail onychomycosis between terbinafine and itraconazole after suc- cessful treatment （RR =0. 33 and 95% CI 0. 15 -0. 73 for sub-group one; RR = 0. 51 ,and 95% CI 0. 37 0. 72 for sub-group two）. Conclusion The present study suggests that mycological recurrence rates are lower in toenail onychomycosis treated with terbinafine than that treated with itraeonazole. Further RCTs are required to confirm the accurate mycological recurrence of onyehomycosis after treatment with terbinafine and itracnazole.

关 键 词：甲真菌病 特比萘芬 伊曲康唑 复发 META分析 

分 类 号：R756.4[医药卫生—皮肤病学与性病学]