钙通道阻滞剂对比硝酸酯类药物治疗慢性肛裂的临床疗效及安全性评价的Meta分析  

Clinical efficacy and safety of calcium channel blockers versus nitrates treating chronic anal fissure:a Meta analysis

作　　者：杜天聪 孟强[1] 邹杰[1] 李强[1] 

机构地区：[1]中国医科大学附属第一医院肛肠外科,辽宁沈阳110001

出　　处：《中国医药导报》2017年第26期113-117,共5页China Medical Herald

摘　　要：目的评价钙通道阻滞剂与硝酸酯类药物治疗慢性肛裂的临床疗效及安全性差异。方法计算机检索中国生物医学文献数据库、中国知网、万方数据库、维普中文科技期刊数据库、Pub Med、Embase、Crochane Library、Web of science和Clinical Trials中关于钙通道阻滞剂和硝酸酯类药物治疗慢性肛裂的临床随机对照试验,检索时间为建库至2017年5月1日。对符合纳入标准的研究进行资料提取和文献质量评价,应用Review Manager 5.3及Stata 14.0进行Meta分析。结果最终有11项研究共862例患者纳入分析。Meta分析结果示,钙通道阻滞剂在提高治愈率及降低复发率方面均优于硝酸酯类药物[RR=1.13,95%CI(1.04,1.23),P=0.003;RR=0.68,95%CI(0.49,0.95),Z=2.28,P=0.02]。钙通道阻滞剂在降低副作用发生率方面较硝酸酯类药物有显著优势[RR=0.31,95%CI(0.19,0.53),P<0.01]。结论钙通道阻滞剂治疗慢性肛裂的临床疗效与安全性优于硝酸酯类药物。Objective To evaluate the clinical efficacy and safety of calcium channel blockers （CCBs） and nitrates in the treatment of chronic anal fissure. Methods Clinical randomized control trials regarding CCBs and nitrates treating chronic anal fissure were searched in databases of CBMdisc, CNKI, Wanfang Database, VIP, PubMed, Embase, Crochane Library, Web of science, Clinical Trials and from their inception to May 1st 2017. The quality of RCTs was appraised and data were extracted. Review Manager 5.3 and Stata 14.0 were used for Meta analysis. Results 11 literatures with 862 patients were included finally. The Meta-analysis showed the effects of CCBs on improving the cure rate and reducing the incidence of recurrence were better than those of nitrates [RR=1.13, 95%CI （1.04, 1.23）, P=0.003; RR=0.68, 95%CI （0.49, 0.95）, Z=2.28, P=0.02]. The effect of CCBs on reducing the incidence of side effects was better than that of nitrates [RR=0.31, 95%CI（0.19, 0.53）, P 〈 0.01]. Conclusion CCBs treating chronic anal fissure is superior to nitrates in clinical efficacy and safety.

关 键 词：慢性肛裂 钙通道阻滞剂 硝酸酯类药物 META分析 

分 类 号：R657.1[医药卫生—外科学]