噻唑烷二酮类治疗溃疡性结肠炎疗效的荟萃分析

The efficacy of thiazolidinediones in treatment of ulcerative colitis: a Meta-analysis

目的采用Meta分析方法对噻唑烷二酮类药物(罗格列酮、吡格列酮)治疗溃疡性结肠炎的疗效进行系统评价。方法以"噻唑烷二酮"、"罗格列酮"、"吡格列酮"、"溃疡性结肠炎"、"随机对照试验"为检索词,检索PubMed、CNKI、WanFang Data、CBM、Google数据库,并追溯参考文献进行全面的文献检索。根据纳入与排除标准筛选文献,提取数据并评价质量,用Review Manager 4.3软件进行Meta分析,同时进行敏感性分析及发表偏倚的评估。结果本研究共纳入文献6篇,经Meta分析,噻唑烷二酮类能明显降低溃疡性结肠炎的疾病活动评分(UCAI)(WMD=-0.92,95%CI:-1.17^-0.66,P<0.00001);噻唑烷二酮类明显增加溃疡性结肠炎的有效缓解人数(OR=12.31,95%CI:1.71~88.74,P=0.01);噻唑烷二酮类药物能明显改善溃疡性结肠炎的组织学分级,尤其是0~Ⅰ级(OR=2.71,95%CI:1.55~4.72,P=0.0004)。失效安全数结果显示,发表偏倚较小。敏感性分析研究表明结果稳定可靠。结论噻唑烷二酮类药物能显著提高溃疡性结肠炎的临床疗效。

Objective To assess the efficacy of thiazolidinediones （TZDs） in treatment of ulcerative colitis by Meta- analysis among domestic and foreign published pertinent articles scientifically. Methods Pertinent literatures on the re- lationship between thiazolidinediones and ulcerative colitis were searched in PubMed, CNKI, WanFang Data, CBM and Google, the searching terms ＂thiazolidinedione＂ , ＂rosiglitazone＂ , ＂pioglitazone＂ , ＂ulcerative colitis＂ , ＂randomized controlled trial＂ were used. Meanwhile, relative journals were looked up by references. According to the inclusion and exclusion criteria, the data were extracted and the methodological quality was evaluated. Then the Meta-analysis was conducted by RevMan 4.3 soft ware, and the sensitivity analysis and publication bias were evaluated at the same time. Results Six randomized controlled trials were included, TZDs significantly reduced the ulcerative colitis disease activity score （UCAI） （ WMD = - 0.92, 95% CI： - 1. 17 ～ - 0.66, P 〈 0. 00001 ） ; TZDs significantly improved the effective remission of UC （ OR = 12.31, 95% CI： 1.71 ～ 88.74, P =0.01 ） ; TZDs significantly increased the histological grad- ing of ulcerative colitis, especially grade 0 to I （ OR =2, 71, 95% CI： 1.55 ～4.72, P =0. 0004）. The fail-safe num- ber calculation suggested little publication bias. The sensitivity analysis showed that outcome of this research work was stable and reliable. Conclusion TZDs can significantly improve the clinical efficacy of ulcerative colitis.