泛昔洛韦与阿昔洛韦治疗带状疱疹的疗效及安全性系统评价

Efficacy and Security of Famciclovir vs.Acyclovir for Treating Herpes Zoster: A Meta-analysis

目的系统评价泛昔洛韦与阿昔洛韦治疗带状疱疹的疗效及安全性。方法采用循证医学的文献分析评价方法,计算机检索Cochrane图书馆、Pubmed、EMbase、中国生物医学文献光盘数据库、中国期刊全文数据库、维普中文科技期刊、万方数字化期刊群等数据库,时间为建库至2015年12月,全面收集泛昔洛韦与阿昔洛韦治疗带状疱疹的有效性和安全性的随机对照试验。评价纳入研究的方法学质量,提取有效数据,采用Rev Man 5.3软件对数据进行Meta分析。结果检索到泛昔洛韦与阿昔洛韦治疗带状疱疹的有效性及安全性的随机对照试验共30篇。痊愈率合并效应量OR=2.11,95%CI(1.73,2.57),P<0.000 01,总有效率合并效应量OR=2.58,95%CI(1.92,3.48),P<0.000 01,安全性合并效应量OR=1.10,95%CI(0.80,1.51),P=0.56,泛昔洛韦治疗带状疱疹疗效优于阿昔洛韦,两种药物安全性差异无统计学意义。结论泛昔洛韦治疗带状疱疹疗效优于阿昔洛韦,安全性与阿昔洛韦相当。但由于纳入的研究数量有限,该系统评价的结果需谨慎对待,尚需更多的设计合理、多中心、大样本的随机对照实验以进一步证实。

Objective To evaluate the efficacy and security of famciclovir and acyclovir in the treatment of herpes zoster.Methods Literature analysis based on evidence-based medicine was performed.Computer retrieval from Cochrane library,Pubmed,EMbase,China biomedical literature database,Chinese Journal Full-text Database,VIP Chinese sci-tech periodicals and Wanfang Digital Periodicals was conducted to search for randomly controlled trials about the effects of famciclovir and acyclovir on herpes zoster from inception to December 2015.The quality of included studies was evaluated.Data were extracted into a specially designed extraction form.The Cochrane collaboration’s RevMan5.3 software was used for meta-analysis.Results The meta-analysis of 30 included RCTs showed that famciclovir was significantly effective in treating herpes zoster compared with acyclovir.The combined effect of cure rate OR=2.11,95%CI(1.73,2.57),P<0.000 01,the combined effect of total effective rate OR=2.58,95%CI(1.92,3.48),P<0.000 01,the combined effect of security OR=1.10,95%CI(0.80,1.510,P=0.56.There was no significant difference in the safety of the two drugs.Conclusion It has been demonstrated that famciclovir is is more effective in the treatment of herpes zoster compared with acyclovir.The security is equivalent.High-quality large-scale multiple-centered sample RCT is required.