【摘要】：目的:采用Meta分析方法對胸腺五肽輔助治療慢性阻塞性肺疾病(COPD)的臨床療效及安全性進(jìn)行評價,為臨床應(yīng)用及輔助用藥管理提供循證參考。方法:計算機檢索PubMed、Embase、Cochrane Library、相關(guān)期刊論文(CNKI)、萬方數(shù)據(jù)庫、維普數(shù)據(jù)庫(VIP)、中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(各數(shù)據(jù)庫檢索時間均從建庫至2016年1月),收集胸腺五肽輔助治療COPD的隨機對照試驗。由2名研究者按照納入與排除標(biāo)準(zhǔn)獨立篩選試驗、提取資料、評價方法學(xué)質(zhì)量,采用RevMan 5.3軟件進(jìn)行統(tǒng)計分析。結(jié)果:共納入16項研究,對研究進(jìn)行合并分析,結(jié)果顯示,胸腺五肽輔助治療COPD,有效性高于常規(guī)治療組[RR=1.18,95%CI(1.05,1.32),P=0.004],可使患者FEV1得到顯著改善[SMD=0.64,95%CI(0.20,1.09),P=0.005],使患者外周血CD4+水平[WMD=6.25,95%CI(3.02,9.48),P=0.000 1]及CD8+水平顯著降低[WMD=-4.60,95%CI(-7.26,-1.94),P=0.000 7],CD4+/CD8+水平顯著升高[WMD=0.42,95%CI(0.24,0.59),P0.000 01]。結(jié)論:基于現(xiàn)有臨床證據(jù),胸腺五肽輔助治療COPD具有一定臨床療效,但由于納入研究證據(jù)強度較低,存在一定的偏倚風(fēng)險,本研究結(jié)論尚需設(shè)計嚴(yán)格的臨床對照試驗進(jìn)一步驗證。
[Abstract]:Objective: to evaluate the efficacy and safety of thymopeptide in adjuvant treatment of chronic obstructive pulmonary disease (COPD) by means of Meta analysis, and to provide evidence-based reference for clinical application and administration of adjuvant drugs. Methods: PubMed,Embase,Cochrane Library, Chinese periodical full-text database, (CNKI), Wanfang database, and Weip database, (VIP), Chinese biomedical literature database, were searched by computer. The retrieval time of each database was from the establishment of the database to January 2016. A randomized controlled trial of thymopeptide adjuvant therapy for COPD was collected. According to the criteria of inclusion and exclusion, two researchers were selected independently to extract the data and evaluate the quality of methodology. The statistical analysis was carried out with RevMan 5.3 software. Results: the combined analysis of 16 studies showed that the efficacy of thymopeptide adjuvant therapy in COPD, was higher than that in routine treatment group [RR=1.18,95%CI (1.051.32), P0. 004]. FEV1 was significantly improved [SMD=0.64,95%CI (0.20 鹵1.09), P < 0.005] and CD4 level in peripheral blood [WMD=6.25,95%CI (3.02 鹵9.48)]. The levels of CD8 and CD4 / CD8 were significantly decreased [WMD=-4.60,95%CI (-7.261-1.94), P0. 000 7] and CD4 / CD8 increased significantly [WMD=0.42,95%CI (0.240.59), P0.00001]. Conclusion: based on the available clinical evidence, thymopeptide adjuvant therapy for COPD has a certain clinical efficacy, but due to the low intensity of evidence included in the study, there is a certain risk of bias. The conclusion of this study needs to be further verified by a strict clinical controlled trial.
【作者單位】： 黃石市第二醫(yī)院藥劑科;華中科技大學(xué)同濟(jì)醫(yī)學(xué)院附屬協(xié)和醫(yī)院藥劑科;首都醫(yī)科大學(xué)附屬北京友誼醫(yī)院藥學(xué)部;
【基金】：湖北省自然科學(xué)基金項目(編號:2015CFB225)
【分類號】：R563.9

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