本文選題：糠酸氟替卡松 + 哮喘　； 參考：《中國循證醫(yī)學(xué)雜志》2017年01期

【摘要】：目的系統(tǒng)評價糠酸氟替卡松治療支氣管哮喘的療效及安全性。方法計算機檢索The Cochrane Library(2016年2期)、Pub Med、CNKI、VIP、Wan Fang Data等數(shù)據(jù)庫,搜集糠酸氟替卡松治療支氣管哮喘的隨機對照試驗(RCT),檢索時間均為建庫至2016年2月。由2位評價者按照納入與排除標準獨立篩選文獻、提取資料并評價偏倚風(fēng)險后,采用Rev Man 5.3軟件進行統(tǒng)計分析。結(jié)果共納入6個RCT,包括4 383例患者。Meta分析結(jié)果顯示:(1)糠酸氟替卡松vs.安慰劑:糠酸氟替卡松不僅能顯著增加一秒用力呼氣量谷值[MD=0.10,95%CI(0.05,0.15),P=0.000 2],且能改善24小時無需使用緩解藥物率和24小時無癥狀率,而不增加治療相關(guān)不良反應(yīng)發(fā)生率[OR=1.38,95%CI(0.28,6.77),P=0.69];(2)糠酸氟替卡松vs.糠酸氟替卡松+維蘭特羅:糠酸氟替卡松+維蘭特羅可顯著增加一秒用力呼氣量谷值[MD= 0.10,95%CI( 0.19, 0.01),P=0.02],且可改善0~24小時加權(quán)平均一秒用力呼氣量、24小時無需使用緩解藥物率及24小時無癥狀率,不增加治療相關(guān)不良反應(yīng)發(fā)生率[OR= 1.05,95%CI( 1.39, 0.80),P=0.72];(3)糠酸氟替卡松vs.丙酸氟替卡松:二者的一秒用力呼氣量谷值[MD= 0.02,95%CI( 0.08,0.04),P=0.52]、24小時無需使用緩解藥物率及治療相關(guān)不良反應(yīng)發(fā)生率[OR=1.62,95%CI(0.77,3.40),P=0.20]均無顯著差異。結(jié)論糠酸氟替卡松較安慰劑可顯著改善患者肺功能,控制哮喘癥狀;糠酸氟替卡松與維蘭特羅聯(lián)用比單用糠酸氟替卡松療效更好,且不增加不良反應(yīng)發(fā)生率;糠酸氟替卡松與丙酸氟替卡松兩者療效相當,但用法更簡便,能很大程度上提高患者的依從性。受納入研究數(shù)量和質(zhì)量所限,上述結(jié)論可能存在偏倚,需開展更多高質(zhì)量研究予以驗證。
[Abstract]:Objective to evaluate the efficacy and safety of fluticasone furoate in the treatment of bronchial asthma.Methods the The Cochrane Library database was searched by computer. The data were collected from a randomized controlled trial of fluticasone furoate in the treatment of bronchial asthma. The retrieval time of the database was established until February 2016.According to the inclusion and exclusion criteria, the two evaluators independently sifted the literature, extracted the data and evaluated the bias risk, and then used Rev Man 5.3 software to carry out statistical analysis.Results A total of 6 RCTs were included, including 4 383 patients. Meta-analysis showed that: 1) fluticasone furoate vs.Placebo: fluticasone furoate not only significantly increased the forced expiratory volume (FVV) of one second [MD0.1095CI0. 05 ~ 0. 15], but also improved the remission rate and asymptomatic rate for 24 hours without increasing the incidence of adverse reactions associated with treatment [OR1.3895CI0.286.77 P0. 69] Fluticasone furoate vs.Fluticasone verantrol furoate: fluticasone furoate significantly increased the forced expiratory volume by one second [MD= 0.10 ~ 95 CI (0.19, 0.01) P0. 02], and improved the weighted average forced expiratory volume of 0 ~ 24 hours per second for 24 hours without the need for a remission drug.Rate and 24 hour asymptomatic rate,The incidence of adverse reactions associated with treatment was not increased [OR = 1.05% 95 CI (1.39, 0.80% P0. 72]) fluticasone furoate vs3).Fluticasone propionate: there was no significant difference in the second forced expiratory volume valley value (MD = 0.02 鹵95) between the two groups (0. 08% 0. 04% P0. 52) and 24 hours no need for remission drug use and the incidence of adverse events associated with treatment [OR1. 6295CII = 0. 77- 3. 40P0. 20].Conclusion Fluticasone furoate can significantly improve pulmonary function and control asthma symptoms compared with placebo the combination of fluticasone furoate and veranbuterol has better efficacy than fluticasone furoate alone and does not increase the incidence of adverse reactions.The efficacy of fluticasone furoate and fluticasone propionate is similar, but it is easier to use and can improve the compliance of patients to a great extent.Limited by the quantity and quality of the studies, these conclusions may be biased and need to be verified by more high-quality studies.
【作者單位】： 重慶醫(yī)科大學(xué)附屬永川醫(yī)院呼吸內(nèi)科;
【分類號】：R562.25

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