【摘要】：目的:利用現(xiàn)有的文獻(xiàn)評(píng)價(jià)沙利度胺治療克羅恩病(Crohn,s disease)的療效與安全性,為臨床治療提供參考依據(jù)。方法:利用計(jì)算機(jī)系統(tǒng)地檢索國(guó)內(nèi)外公開發(fā)表的所有關(guān)于沙利度胺治療克羅恩的相關(guān)文獻(xiàn),檢索日期為2016年8月以前。嚴(yán)格按照納入排除標(biāo)準(zhǔn)進(jìn)行文獻(xiàn)篩選、質(zhì)量評(píng)價(jià)和提取相關(guān)數(shù)據(jù)后,應(yīng)用Rev Man5.3軟件進(jìn)行Meta分析。采用I 2檢驗(yàn)異質(zhì)性,計(jì)數(shù)資料采用相對(duì)危險(xiǎn)度(relative risk,RR)及95%可信區(qū)間(95%confidence interval,95%CI)表示。單組率采用公式RR/(1+RR)合并,相應(yīng)的95%CI區(qū)間(上限值RR/(1+上限值RR),下限值RR/(1+下限值RR)。對(duì)不能進(jìn)行定量Meta分析的指標(biāo),可進(jìn)行描述性研究。結(jié)果:最終符合納入標(biāo)準(zhǔn)的研究共18項(xiàng),病人總數(shù)為381人。Meta分析結(jié)果顯示:沙利度胺治療克羅恩病的臨床緩解率合并RR=0.88,95%CI(0.53~1.48),合并率為46.8%,95%CI(34.6%~59.6%);實(shí)現(xiàn)激素減量率合并RR=1.97,95%CI(0.55~7.09),其合并率66.3%,95%CI(35.4%~87.6%);實(shí)現(xiàn)瘺管閉合率合并RR=0.69,95%CI(0.38~1.26),其總體率為41%,95%CI(27.5%~55.8%);實(shí)現(xiàn)黏膜愈合率合并RR=0.50,95%CI(0.23~1.11),合并率為33%,95%CI(18.7%~52.6%);生物制劑治療失敗后獲得臨床緩解率合并RR=1.72,95%CI(0.88~3.36),其合并率為63.2%,95%CI(46.8%~77.1%)。一共有64.5%的病人發(fā)生了不良反應(yīng),其中25.2%的病人因不良反應(yīng)而停藥。結(jié)論:沙利度胺治療克羅恩病有一定療效,但使用時(shí)需注意其不良反應(yīng)。
[Abstract]:Objective: to evaluate the efficacy and safety of thalidomide in the treatment of Crohn's disease (Crohn,s disease). Methods: all the published literatures on thalidomide therapy for Crohn were systematically searched by computer before August 2016. Literature screening, quality evaluation and extraction of relevant data were carried out strictly according to exclusion criteria. Meta analysis was carried out with Rev Man5.3 software. I 2 was used to test the heterogeneity. The count data were expressed by relative risk (relative risk,RR) and 95% confidence interval (95%confidence interval,95%CI). The univariate rate is combined with the formula RR/ (1 RR), and the corresponding 95%CI interval (upper value RR/ (1 upper value RR), lower limit value RR/ (1 lower limit value RR).) Descriptive studies can be carried out on indicators that cannot be analyzed by quantitative Meta. Results: there were 18 studies that eventually met the inclusion criteria, The results of meta-analysis showed that the clinical remission rate of thalidomide in the treatment of Crohn's disease combined with RR=0.88,95%CI (0.531.48), and the combined rate was 46.8 / 95CI (34.6 / 59.6%), a hormone reduction rate combined with RR=1.97,95%CI (0.557.09), and a combined rate of 66.395CI (35.47.6%), a fistula closure rate combined with RR=0.69,95%CI (0.381.26), and a total rate of 41C _ (95) CI (27.55.58%). The rate of mucosal healing combined with RR=0.50,95%CI (0.231.11), the combined rate was 330.95 CI (18.7%, 52.6%), the rate of clinical remission after the failure of biological agent therapy and RR=1.72,95%CI (0.883.36), the combined rate was 63.2% with 95 CI (77.1%). A total of 64.5% of the patients had adverse reactions, of which 25.2% stopped taking drugs because of adverse reactions. Conclusion: thalidomide is effective in the treatment of Crohn's disease, but attention should be paid to its adverse reactions.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R574.62

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 羅涵青;李s，

本文編號(hào)：2212175