雷公藤多苷联合地氯雷他定治疗慢性荨麻疹疗效与安全性的系统评价

Systematic Review of Efficacy and Safety of Tripterygium Glycosides Combined with Desloratadine in Treatment of Chronic Urticaria

目的:系统评价雷公藤多苷联合地氯雷他定治疗慢性荨麻疹的临床疗效及安全性,为临床决策提供循证参考。方法:检索中国期刊全文数据库、维普数据库、中国生物医学文献数据库、PubMed、EMBase、the Cochrane Library等数据库(2000年1月至2018年4月),收集雷公藤多苷联合地氯雷他定治疗慢性荨麻疹的随机对照研究(观察组患者联合应用雷公藤多苷与地氯雷他定,对照组患者单独应用地氯雷他定),筛选符合纳入标准的文献,应用Juni评分法进行评价,采用RevMan 5.3软件进行文献荟萃分析(Meta分析)。结果:最终纳入11篇文献,均为中文文献。Meta分析结果显示,观察组患者的有效率明显高于对照组(OR=1.32,95%CI=1.23～1.41,P<0.05),复发率明显低于对照组(OR=0.23,95%CI=0.14～0.38,P<0.05),差异均有统计学意义;两组患者不良反应发生率的差异无统计学意义(OR=0.98,95%CI=0.62～1.57,P>0.05)。结论:雷公藤多苷联合地氯雷他定治疗慢性荨麻疹的疗效优于单用地氯雷他定,其不良反应较轻微,更适合作为临床治疗慢性荨麻疹的优选方案。

OBJECTIVE:To systematically evaluate the clinical efficacy and safety of tripterygium glycosides combined with desloratadine in treatment of chronic urticaria,so as to provide evidence-based reference for clinical decision making.METHODS:CNKI,VIP database,CBMdisc,PubMed,EMBase and the Cochrane Library were retrieved(from Jan.2000to Apr.2018),and randomized controlled trial(RCT)of tripterygium glycosides combined with desloratadine in treatment of chronic urticaria(patients in observation group were treated with tripterygium glycosides and desloratadine,and the control group received desloratadine alone)were collected.Literature that met the inclusion criteria were screened,the Juni scoring method was adopted for evaluation,and meta-analysis was conducted by using RevMan5.3software.RESULTS:A total of11literature were included,all in Chinese.Meta-analysis showed that the effective rate of observation group was significantly higher than that of control group(OR=1.32,95%CI=1.23-1.41,P<0.05),and the recurrence rate was significantly lower than that of the control group(OR=0.23,95%CI=0.14~0.38,P<0.05),the difference was statistically significant.There was no significant difference in the incidence of adverse drug reactions between two groups(OR=0.98,95%CI=0.62-1.57,P>0.05).CONCLUSIONS:Tripterygium glycosides combined with desloratadine is superior to desloratadine alone in treatment of chronic urticaria with few adverse drug reactions,it is more suitable as a preferred treatment for chronic urticaria.