阿苯达唑不同剂型治疗包虫病效果的Meta分析  

Meta analysis of the efficacy of albendazole in the treatment of echinococcosis

作　　者：马瑞佳 巩月红[2] 吾斯曼江·艾买提 赵美玲 王建华[2] MA Ruijia;GONG Yuehong;Wusimanjiang Aimaiti;ZHAO Meiling;WANG Jianhua(College of Pharmacy,Xinjiang Medical University,Urumqi,830011,China;Department of Pharmacy,the First Affiliated Hospital of Xinjiang Medical University,Urumqi,830054,China)

机构地区：[1]新疆医科大学药学院,乌鲁木齐830011 [2]新疆医科大学第一附属医院药学部,乌鲁木齐830054

出　　处：《新疆医学》2022年第2期139-145,150,共8页Xinjiang Medical Journal

基　　金：国家自然科学基金(项目编号:81860666);新疆维吾尔自治区自然科学基金(项目编号:2020D01C240,2021D01D15);新疆重大疾病防治与转化协同创新中心资助项目(项目编号:80910721);省部共建中亚高发病成因与防治国家重点实验室开放课题项目(项目编号:SKL-HIDCA-2020-1)。

摘　　要：目的 系统评价阿苯达唑(ABZ)不同剂型治疗包虫病的效果。方法 计算机检索PubMed、EMBase、Cochrane图书馆、Web of Science、CNKI、VIP、WanFang Data和CBM数据库,收集ABZ不同剂型治疗包虫病的随机对照试验(RCT),检索时限均从建库至2020年6月。由2名研究者对纳入的临床研究独立筛选文献、提取资料并评价纳入研究的偏倚风险,另外2名研究者对纳入的动物实验进行共10个条目的质量评价。两种资料均采用Rev Man 5.3软件进行Meta分析。结果 分别纳入5篇临床研究以及10篇动物实验,包括350例患者,1076只小鼠。临床研究Meta分析结果显示:ABZ乳剂疗效显著高于ABZ片剂以及未经药物治疗[OR=3.77,95%CI(1.81,7.82),P=0.0004]。而ABZ脂质体与ABZ片剂疗效差异无统计学意义。动物实验Meta分析结果显示:相较于未经药物干预的模型对照组,ABZ壳聚糖微球、脂质体、片剂、粉剂、混悬剂均有成效。与片剂相比,壳聚糖微球治疗效果较佳,[SMD=-3.79,95%CI(-7.12,-0.47),P=0.03]。根据不同剂量进行亚组分析,各亚组的差异均有统计学意义[SMD=-3.00,95%CI(-4.85,-1.16),P=0.001];ABZ脂质体与片剂在剂量同为75mg/kg时差异无统计学意义,在剂量同为37.5 mg/kg,150 mg/kg时,差异具有统计学意义[SMD=-2.09,95%CI(-3.26,-0.92),P=0.005]。结论 当前证据表明,在临床上,ABZ乳剂可以提高包虫病病人疗效;在动物实验中,与片剂相比,壳聚糖微球治疗效果较佳,ABZ脂质体与片剂在剂量为37.5mg/kg,150mg/kg时,差异具有统计学意义。但受纳入研究数量和质量的限制,本研究结论尚需开展更多高质量研究予以证实。Objective To evaluate the efficacy of different dosage forms of albendazole(ABZ)in the treatment of echinococcosis.Methods Pub Med, EMBASE, Cochrane Library, web of science, CNKI, VIP, Wanfang Data and CBM databases were searched to collect randomized controlled trials(RCTs)of different dosage forms of ABZ in the treatment of echinococcosis. The retrieval time was from the establishment of the database to June 2020. Two researchers independently searched the literatures, extracted data and evaluated the bias risk of the included studies, and the other two researchers conducted a total of 10 item quality evaluation on the included animal experiments. Rev man 5.3 software was used for Meta analysis. Results Five clinical studies and 10 animal experiments were included,including 350 patients and 1076 mice. Meta analysis of clinical studies showed that the efficacy of ABZ emulsion was significantly higher than that of ABZ tablet and without drug treatment [OR = 3.77, 95% CI(1.81,7.82), P = 0.0004]. There was no significant difference between ABZ liposome and ABZ tablet. The results of meta-analysis of animal experiments showed that compared with the model control group without drug intervention, ABZ chitosan microspheres, liposomes, tablets, powders and suspensions were effective. Compared with tablets, chitosan microspheres had better therapeutic effect [SMD =-3.79, 95% CI(-7.12,-0.47), P = 0.03]. According to the subgroup analysis of different doses, the differences of each subgroup were statistically significant [SMD =-3.00, 95% CI(-4.85,-1.16), P =0.001]. There was no significant difference between ABZ liposome and tablet at the same dose of 75mg/kg, but there was significant difference at the same dose of 37.5mg/kg, 150mg/kg [SMD =-2.09, 95% CI(-3.26,-0.92), P = 0.005]. Conclusions The current evidence shows that ABZ emulsion can improve the curative effect of echinococcosis patients in clinic. Compared with tablets, chitosan microspheres have better therapeutic effect in animal experiments. The effect between A

关 键 词：阿苯达唑 剂型 包虫病 疗效 系统评价 

分 类 号：R944.9[医药卫生—药剂学]