甲硝唑和克林霉素治疗细菌性阴道病有效性及安全性比较的Meta分析

Comparison of efficacy and safety between metronidazole and clindamycin in treatment of bacterial vaginosis: a meta-analysis

目的比较甲硝唑和克林霉素治疗细菌性阴道病(BV)的有效性及安全性。方法计算机检索PubMed、 Cochrane Library和Embase数据库中自建库至2018年2月1日公开发表的关于甲硝唑和克林霉素治疗BV的随机对照试验(RCT)。采用RevMan 5.3软件进行Meta分析。结果共纳入7项RCT,合计1 039例患者。Meta分析结果显示,甲硝唑和克林霉素治疗BV的治愈率差异无显著意义(RR=0.94, 95%CI:0.86～1.02, P=0.13)。在主要不良反应发生率方面,甲硝唑组恶心发生率高于克林霉素组(RR=10.95, 95%CI:2.56～46.78, P=0.001);而外阴阴道假丝酵母菌病、腹泻发生率两组比较均无显著差异(P> 0.05)。结论甲硝唑和克林霉素治疗BV的临床疗效相当,但克林霉素恶心发生率低于甲硝唑。

AIM To compare the efficacy and safety of metronidazole and clindamycin in the treatment of bacterial vaginosis(BV). METHODS The PubMed, Cochrane Library and Embase databases were searched by computer. The randomized controlled trials(RCT) about the metronidazole and clindamycin in the treatment of BV were selected from inception to February 1, 2018. Meta-analysis was performed by using RevMan 5.3 software. RESULTS A total of 7 RCT involving 1 039 patients were included. The meta-analysis showed no significant difference in the cure rate of metronidazole and clindamycin in the treatment of BV(RR = 0.94, 95%CI: 0.86-1.02, P = 0.13). In the incidence of major adverse reactions, the incidence of nausea in the metronidazole group was higher than that in the clindamycin group(RR = 10.95, 95% CI: 2.56-46.78, P =0.001). However, there was no significant difference in the incidence of vulvovaginal candidiasis and diarrhea between the two groups(P > 0.05). CONCLUSION The clinical efficacy of metronidazole and clindamycin in the treatment of BV is comparable, but the incidence of clindamycin induced nausea was lower than metronidazole.