非甾体类抗炎药治疗家族性腺瘤性息肉病临床疗效的系统评价

Clinical effect of non-steroidal anti-inflammatory drugs on polyps in familial adenomatous polyposis patients: systematic review

目的系统回顾非甾体类抗炎药（non-steroidal anti-inflammatory drugs,NSAIDs）在治疗家族性腺瘤性息肉病（familial adenomatous polyposis FAP）的临床疗效及安全性。方法检索Pub Med、Medline、EMBASE、ISI、SCI/SSCI/A＆HCI及Collaboration Controlled Trial Register数据库、中文数据库检索中国知网（CNKI）、万方数据库（Wan Fang Data）、维普数据库（VIP）和中国生物医学文献数据库（CBM）,查找NSAIDs治疗FAP的临床疗效的前瞻性研究,检索时间均为建库至2014年7月。同时手工检索纳入文献的参考文献。按纳入和排除标准,2位研究者独立进行文献筛选、资料提取,采用Rev Man 5.2软件对NSAIDs治疗FAP的研究进行系统评价。结果纳入12篇文献,502例患者。对此12篇文献进行系统描述,在减少FAP患者腺瘤性息肉的直径及大小方面,NSAIDs与安慰剂相比差异无统计学意义。无足够证明证实NSAIDs可降低FAP患者腺瘤性息肉的直径及大小;其中6篇文献的结局指标为FAP息肉的好转,对此6篇文献进行Meta分析,结果显示与安慰剂比较,NSAIDs可使息肉好转（RR=6.17,95%CI：2.31~16.51）;大多数研究明确表明NSAIDs在治疗FAP患者时,具有较好的耐受性。结论 FAP患者对NSAIDs有较好耐受,对于FAP患者,NSAIDs可作为一种治疗选择。

Objective To assess the clinical effect and safety of non-steroidal anti-inflammatory drugs （NSAIDs） in the treatment of familial adenomatous polyposis （FAP）. Methods A comprehensive search from the establishment of the database to Jul. 2014 was conducted in PubMed, Medline, EMBASE, ISI, SCI/SSCI/A＆HCI and Collaboration Controlled Trial Register, CNKI, WanFang Data, VIP, and CBM to identify relevant prospective studies. The bibliogra- phies of the included studies were also searched. After selection, assessment and data were collected by 2 reviewers in- dependently. Meta-analysis was performed by the RevMan 5.2 software. Results Twelve studies involving 502 patients met the including criteria. There was no enough evidence that NSAIDs could decrease the diameter or size of the polyps in FAP patients. The results of Meta-analysis including 6 studies showed that： the number of patients that had the re- gression of polyps in NSAIDs group was more than placebo group （RR = 6.17,95% CI： 2.31 - 16.51 ）. The incidence of adverse events could he tolerated in most studies. Conclusion NSAIDs can be used as an adjuvant therapy in FAP patients,and NSAIDs are safe.