沙利度胺治疗强直性脊柱炎的Meta分析

Efficacy of thalidomide in treating ankylosing spondylitis:A Meta-analysis

目的:系统评价沙利度胺治疗强直性脊柱炎的疗效。方法:计算机检索CBM、CNKI、万方数据库、Medline,收集沙利度胺治疗强直性脊柱炎的随机试验,由两位研究者按照纳入与排除标准独立进行资料提取,并根据CochraneReviewer’s Handbook5.0对纳入的研究进行质量评价和提取有效数据,然后应用RevMan 5.1软件进行Meta分析。结果:共纳入6个随机试验,共计445例患者,Meta分析结果显示,沙利度胺治疗组和对照组在总有效率、Bath强直性脊柱炎病情活动指数调查表(Bath ankylosing spondylitis disease activity index,BASDAI)、血沉、枕壁距方面,两组间差异有统计学意义;而在C反应蛋白、指地距方面,两组间差异无统计学意义。"漏斗图"是不对称分布,提示可能存在发表偏倚。结论:沙利度胺治疗组在治疗强直性脊柱炎患者疗效方面优于对照组,但由于纳入的研究数量少、质量低以及可能存在发表偏倚,需要大样本、多中心、高质量的随机对照双盲试验进一步验证其疗效。

Objective： To efficacy of thalidomide in Treating ankylosing spondylitis. Methods： Randomized controlled tials （RCTs） about the etfect of thalidomide on patient with AS were collected by searching CBM, CNKI, WanFang Data, Medline. The studies were extracted according to the inclusion and exclusion criteria by two researchers independently, the methodolofical quality and data extraction of the selective studies were assessed by Reviewer＇s Handbook5.0, then the data were analyzed by RevMan 5.1 software. Results： Six randomized controlled trials including 445 patients met the inclusion criteria. Meta-analysis showed that significant differeces exsisted between thalidomide treatment group and control group at overall effectiveness, BASDAI, ESR, oceiput to wall distance, while no differnces exsisted between the two groups at CRP, finger to floor distance. A ＂Funnel plot＂ show asymmetry, it indicated possible publication bias. Conclusion： Thalidomide treatment group is effective for treating ankylosing spondylitis than control group. But because of limited quantity and low quality of included studies, and publication bias, large-scale, multi-centers and rigorous designs of randomized, double- blind researchs are needed to further assess the effeet.