不同药物治疗中国间歇性跛行患者临床疗效的网状Meta分析

Clinical outcomes of different drugs for intermittent claudication in Chinese patients:a network meta-analysis

目的评价贝前列素钠、西洛他唑、沙格雷酯、氯吡格雷和阿司匹林等常用药物治疗中国间歇性跛行患者的临床疗效。方法系统性检索中国学术文献出版总库、万方数据库、PubMed、Medline、Embase和Cochrane数据库从2000年1月至2020年3月符合纳入标准的RCT研究,采用Stata进行网状Meta分析和干预措施排序,临床指标为最大步行距离和无痛行走距离。结果共纳入5项RCT研究共240例患者。结果显示在增加最大步行距离方面,疗效排名前两位为贝前列素钠、沙格雷酯,其次为西洛他唑、贝前列素钠联合阿司匹林、空白/安慰剂和阿司匹林;在增加无痛步行距离方面,贝前列素钠、沙格雷酯疗效位于前两位,其次为贝前列素钠联合阿司匹林、西洛他唑和阿司匹林。结论贝前列素钠在提高中国间歇性跛行患者最大步行距离和无痛步行距离方面疗效确切且相对较优,可明显改善患者的活动能力。

Objective To evaluate the therapeutic effects of commonly used drugs such as beraprost sodium,cilostazol,sarpogrelate,clopidogrel and aspirin for the treatment of intermittent claudication in Chinese patients.Methods We systematically searched China National Knowledge Infrastructure,Wanfang Data,PubMed,Medline,Embase,and Cochrane database to select RCT research that met the inclusion criteria published between January 2000 and March 2020.Stata was used to conduct network meta-analysis and the outcome measures were maximum walking distance and pain-free walking distance.Results Five RCTs were included,covering in total 240 patients.For increasing maximum walking distance,the top two therapies are beraprost sodium and sagregrelate,followed by cilostazol,beraprost sodium combined with aspirin,blank/placebo and aspirin.For increasing pain-free walking distance,the top two therapies are beraprost sodium and sagregrelate,followed by beraprost sodium combined with aspirin,cilostazol and aspirin.Conclusion Beraprost sodium has better therapeutic effect in improving maximum walking distance and pain-free walking distance for Chinese intermittent claudication patients,which can significantly improve the mobility of patients.