利福昔明治疗肠易激综合征疗效与不良反应Meta分析

Meta-analysis of the efficacy and adverse events of rifaximin in treatment of patients with irritable bowel syndrome

目的评价利福昔明治疗肠易激综合征（irritable bowel syndrome,IBS）患者的疗效与不良反应。方法检索Pubmed、Web of Science、Google scholor、Medline及The Cochrane Library数据库及中国期刊全文数据库、中国维普全文数据库、万方医学全文数据库中1950年1月1日-2014年5月29日发表的关于利福昔明治疗IBS的临床随机对照试验的研究。评价的主要终点事件为IBS患者全身症状改善情况（global symptom improvement,GLSI）,次要终点事件为腹胀改善情况及治疗过程、随访期间的不良反应事件。结果与安慰剂组比较,利福昔明可明显改善IBS患者全身症状（OR=1.55,95%CI：1.32~1.84,I2=17%）;IBS相关腹胀缓解现象显著（OR=1.56,95%CI：1.32~1.85,I2=0%）;短期不良反应事件发生率较低（OR=0.81,95%CI：0.66~0.99,I2=0%）。结论 Meta分析结果显示利福昔明可能较安慰剂组明显改善患者全身症状及腹胀情况,有较低的不良反应发生率,值得进一步研究。

Objective To evaluate the efficacy and adverse events of rifaximin in treatment of patients with irritable bowel syndrome （IBS）. Methods Randomized controlled trials of rifaximin in patients with IBS were searehed in PubMed, Web of Science, Google scholor, Medline and Cochrane Library, China Academic Literature Full-text Data- base, Chinese VIP Full-text Database, Wanfang medical Full-text Database from Jan. 1950 to May. 2014. The global symptom improvement （GLSI） of IBS after treatment as primary endpoint and bloating improvement and adverse events （AEs） during the treatment and follow-up as secondary endpoints were evaluated. Results Compared with placebo group, rifaximin could obviously improve the global symptoms of IBS （ OR = 1.55, 95% CI： 1.32 - 1.84, 12 = 17% ）. The phenomenon of IBS related bloating relieved significantly （ OR = 1.56, 95% CI： 1.32 - 1.85, 12 = 0% ） ; short- term rate of adverse events was lower （ OR = 0. 81, 95% CI： 0. 66 -0. 99, 12 = 0% ）. Conclusion The results of the Meta-analysis suggest that rifaximin may improve the global symptoms and bloating of IBS significantly and have a lower rate of adverse events compared with the placebo group.