卷曲霉素对比链霉素治疗复治、耐药肺结核的系统评价

Systematic Review of Capreomycin vs. Streptomycin in the Treatment of Relapsing Drug-resistance Tuberculosis

目的:采用循证医学的方法评价卷曲霉素对比链霉素治疗复治、耐药肺结核的有效性和安全性。方法:计算机检索Cochrane Library、PubMed、EMBASE、CBM、CNKI、VIP、万方数据库,按纳入与排除标准选择试验,并对其进行质量评价。用RevMan5.0软件对数据进行Meta分析。结果:共纳入8项研究,Meta分析结果显示,卷曲霉素组痰菌转阴率、病灶吸收率和空洞改变情况均优于链霉素组,差异具有统计学意义(P<0.05);尚不能认为2组不良反应发生率有差异。结论:现有证据表明,卷曲霉素与其他抗结核药联用治疗复治、耐药肺结核的疗效优于链霉素联用的方案;但由于纳入的文献数量有限、研究质量不高,上述结论还需大样本高质量的随机对照试验加以验证。

OBJECTIVE： To evaluate the effectiveness and safety of capreomycin vs. streptomycin in the treatment of relapsing drug-resistance tuberculosis by evidence-based medicine. METHODS： Literatures were retrieved from Cochrane Library, PubMed, EMBASE,CBM,CNKI,VIP,Wangfang databases by computer. Literatures were enrolled according to including criteria and excluding criteria, the quality were evaluated and Meta-analysis was conducted by RevMan 5.0 software. RESULTS： Meta-analysis of 8 included RCTs showed that the sputum culture conversion rate, focus absorption rate, cavity change rate in capreomycin group were significantly better than in streptomycin group, there was statistical significance （P〈0.05）. There was no statistical significant difference in the incidence of adverse drug reactions, and difference hadn’t been found in two groups. CONCLUSION： The analysis indicates that capreomycin combined with other antituberculosis is better than combined use of streptomycin in the treatment of relapsing drug-resistance tuberculosis. Because of the limit of quality and quantity of included literatures, large-scale high-quality RCTs are required for validation.