干扰素联合口服抗病毒药物治疗中国人生殖器疱疹的荟萃分析

Systematic Review Meta-Analysis of Interferon Combined with Oral Antiviral Medicine for Genital Herpes in China

目的对中国地区干扰素联合口服抗病毒药物治疗生殖器疱疹的安全性和有效性进行荟萃分析。方法分别在中国知网、万方数据库和维普中文数据库和PubMed、EMbase外文数据库上检索所有干扰素联合口服抗病毒药物治疗生殖器疱疹的随机对照试验,以临床治疗总有效率、平均治愈时间、复发率、不良反应发生率和类型作为结局指标,评价其有效性和安全性。采用Cochrane手册的标准评价纳入研究的质量,对有足够相似性的资料使用RevMan5.3软件进行荟萃分析,根据不同干预措施进行敏感度分析和发表偏移分析。结果共纳入16篇中文文献合计1 515例生殖器疱疹患者。荟萃分析表示,干扰素联合口服抗病毒药物治疗组在平均治愈时间(MD=-2.155, 95%CI:-3.04~-1.26,P<0.01)和复发率(RR=0.50, 95%CI:0.43~0.59,P<0.01)方面较单独使用口服抗病毒药物有优势。实验组与对照组之间,总有效率(RR=1.15, 95%CI:0.93~1.42,P>0.05)及不良反应发生率(RR=0.59, 95%CI:0.32~1.12,P=0.11)方面没有明显的差异。两组患者的不良反应均较少见,并且较轻微,可通过对症治疗改善或自行缓解。结论与单纯使用口服抗病毒药物相比,干扰素联合口服抗病毒药物治疗生殖器疱疹可以有效缩短疗程、减少复发,且安全性好。

Objective To conduct a meta-analysis of the safety and efficacy of interferon combined with oral antiviral medicine for the treatment of genital herpes in China.Methods All randomized controlled trials(RCTs) of interferon combined with antiviral drugs for genital herpes were searched in CNKI, Wanfang Database, VIP Database, PubMed, and EMbase database, respectively.The clinical outcomes of the total treatment efficiency rate, average heal time, relapse rate, adverse reaction rate and type were collected to evaluate IFN′s efficacy and safety.The methodological quality of included studies was evaluated using Cochrane Handbook criteria.The RevMan5.3 software was used for sensitivity analysis and publication bias analysis.Results A total of 16 RCTs involving 1 515 patients with genital herpes were included.The meta-analysis indicated that average heal time(MD=-2.155, 95%CI:-3.04~-1.26, P<0.01) was shorter and relapse rate(RR=0.50, 95%CI:0.43~0.59, P<0.01) was lower in IFN combined with oral antiviral medicine group.There was no significant difference in terms of total efficiency rate(RR=1.15, 95%CI:0.93~1.42, P>0.05) and adverse reaction rate(RR=0.59, 95%CI:0.32~1.12, P=0.11).Adverse reactions were rare and mild in both groups and could be improved by symptomatic treatment.Conclusion Compared with the use of oral antiviral drugs alone, interferon combined with oral antiviral drugs for genital herpes can effectively shorten the course, reduce recurrence with good safety.