纳美芬治疗急性酒精中毒有效性及安全性的meta分析  

Efficacy and safety of nalmefene in treatment of acute alcoholic intoxication: a meta-analysis

作　　者：许忠波 朱素有 廖为民[1] 胡子毅[1] 魏明全[1] 冯欣[2] XU Zhong-bo;ZHU Su-you;LIAO Wei-min;HU Zi-yi;WEI Ming-quan;FENG Xin(Emergency Department, Affiliated Hospital ofjiangxi University of Chinese Medicine, Nanchang 330006, China;Health Education Department, Maternal and Child Health Hospital of Jiangxi Province, Nanehang 330006, China)

机构地区：[1]江西中医药大学附属医院急诊科,南昌330006 [2]江西省妇幼保健院健康教育科,南昌330006

出　　处：《临床药物治疗杂志》2018年第3期62-67,共6页Clinical Medication Journal

基　　金：江西省卫生计生委科技计划资助项目(20175334)

摘　　要：目的:评价纳美芬治疗急性酒精中毒的有效性及安全性。方法:对中国知网、万方数据库、中国生物医学数据、Embase、Pubmed、Cochrane library进行检索,检索截至2017年4月公开发表的随机对照临床试验。按照纳入和排除标准对检索文献进行筛选,评价文献质量,提取文献数据,采用Rev Man5.3软件进行meta分析。结果:共纳入文献11篇,患者合计1 240例,meta分析结果示:试验组能明显提高1、2、3 h有效率及总有效率[(OR=4.39,95%CI:2.73~6.90,P<0.001)、(OR=5.36,95%CI:3.35~8.57,P<0.001)、(OR=6.55,95%CI:2.90~14.76,P<0.001)、(OR=5.03,95%CI:2.91~8.71,P<0.001)],能明显缩短清醒、症状消失、症状减轻及起效时间[(MD=-35.79,95%CI:-47.90^-23.68,P<0.001)、(MD=-170.99,95%CI:-173.12^-168.85,P<0.001)、(MD=-42.35,95%CI:-43.80^-40.90,P<0.001)、(MD=-27.32,95%CI:-28.59^-26.05,P<0.001)],试验组不良反应发生率较少(RR=0.19,95%CI:0.10~0.37,P<0.001)。结论:纳美芬治疗急性酒精中毒临床疗效优于其他药物治疗,且不良反应发生率低。由于本研究存在一定局限性,结论仍需高质量的临床试验研究加以验证。Objective： To study the efficacy and safety of nalmefene in treatment of acute alcoholic intoxication. Methods： The databases of CNKI, Wanfang, CMB, Pubmed, Embase, and Cochrane library were searched to collect randomized controlled trials published before April, 2012. The retrieved studies were selected according to the inclusion and exclusion criteria, the quality was evaluated, and the data was extracted. Meta-analysis was carried using Rev Man 5.3 software. Results： Eleven RCTs were included, involving 1 240 patients. Meta-analysis showed that nalmefene could obviously improve the effective rates at 1, 2, 3 h and the total effective rate [OR=4.39, 95%CI：2.73-6.90, P〈0.001; OR=5.36, 95%CI：3.35-8.57, P〈0.001; OR=6.55, 95%CI：2.90-14.76, P〈0.001; OR=5.03,95%CI：2.91-8.71, P〈0.001]. The awake time, symptom disappearing time, symptom relieve time, and effect onset time of the experiment group were obviously reduced [MD=-35.79,95%CI：-47.90--23.68, P〈0.001; MD=-170.99, 95%CI：-173.12--168.85, P〈0.001; MD=-42.35, 95%CI：-43.80--40.90, P〈0.001; MD=-27.32,95%CI：-28.59--26.05, P〈0.001]. The incidence of adverse effects was lower in the experiment group[RR=0.19, 95%CI：0.10-0.37, P〈0.001]. Conclusion： Nalmefene has better curative effect on acute alcoholic intoxication and lower incidence of adverse effects than other medications. However, due to the limitations of this study, more RCTs with rigorous design are needed for further confirmation.

关 键 词：纳美芬 急性酒精中毒 META分析 随机对照试验 

分 类 号：R971.7[医药卫生—药品]