摘要
目的系统评价升血小板胶囊联合激素治疗特发性血小板减少性紫癜(ITP)的有效性。方法计算机检索PubMed(1966~2012)、CENTRAL(2012年第3期)、CBM(1978~2012)、CNKI(1979~2012)、WanfangData(1998~2012)、VIP(1991~2012)等数据库,收集升血小板胶囊联合激素治疗特发性血小板减少性紫癜的随机对照试验(RCT),并追溯纳入研究的参考文献。由两位研究者按照纳入与排除标准独立筛选文献、提取资料和评价质量后,采用RevMan 5.1软件进行Meta分析。结果共纳入10个RCT,588例患者。Meta分析结果显示:在治疗特发性血小板减少性紫癜的总有效率[RR=1.18,95%C(I1.06,1.32),P=0.003]、显效率[RR=1.57,95%C(I1.29,1.91),P<0.000 01]、治疗后血小板计数[MD=21.54,95%CI(13.85,29.23),P<0.000 01]方面,升血小板胶囊联合激素治疗组均优于单纯激素治疗组,且升血小板胶囊联合激素治疗组的复发率更低[RR=0.49,95%CI(0.34,0.69),P<0.000 1]。结论现有证据显示,升血小板胶囊联合激素组治疗特发性血小板减少性紫癜的疗效优于单纯激素组。但由于缺乏高质量RCT证据支持,上述结论仍待高质量RCT结果进一步验证。
Objective To systematically evaluate the effectiveness of platelet increasing capsule combined with hormone in treating idiopathic thrombocytopenic purpura(ITP).Methods Randomized controlled trials(RCTs) of ITP treated by platelet increasing capsule combined with hormone were electronically searched from PubMed(1966 to 2012),The Cochrane Library(CENTRAL,Issue 3,2012),CBM(1978 to 2012),CNKI(1979 to 2012),WanFang Data(1998 to 2012),and VIP(1991 to 2012).References of included studies were also retrieved.The literature was independently screened according to exclusion and inclusion criteria by two researchers independently and meta-analysis was conducted using RevMan 5.1 software after data extraction and quality assessment.Results 10 RCTs were included involving 588 patients.The results meta-analysis showed that,the group which was treated by platelet increasing capsule combined with hormone was superior to the hormone alone group in the aspects of overall effectiveness rate(RR=1.18,95%CI 1.06 to 1.32,P=0.003),the significant effectiveness rate(RR=1.57,95%CI 1.29 to 1.91,P0.000 01),blood platelet count(MD=21.54,95%CI 13.85 to 29.23,P0.000 01),and the recurrence rate(RR=0.49,95%CI 0.34 to 0.69,P0.000 01) which was lower.Conclusion Current evidence has showed that platelet increasing capsule combined with hormone in treating ITP is better than hormone alone.However,more high quality RCTs are needed to verify the above conclusion in future.
出处
《中国循证医学杂志》
CSCD
2013年第7期852-857,共6页
Chinese Journal of Evidence-based Medicine
关键词
升血小板胶囊
激素
特发性血小板减少性紫癜
系统评价
META分析
随机对照试验
Platelet increasing capsule
Hormone
Idiopathic thrombocytopenic purpura(ITP)
Systematic review
Meta-analysis
Randomized controlled trial