基于循证药学的环磷腺苷类药物临床现状研究

Clinical Status of Cyclic Adenosine Monophosphate Related Drugs Based on Evidence-Based Pharmacy

目的:系统评价环磷腺苷类药物的有效性及安全性。方法:计算机检索PubMed、Embase、the Cochrane Library、中国知网、万方数据库、中国生物医学文献数据库,中文数据库收集建库至2024年1月中国科技论文核心期刊发表的环磷腺苷类药物的系统评价(SR)/Meta分析、随机对照试验(RCT),英文数据库不进行期刊限制。采用描述性分析方式对所纳入的文献进行汇总及总结。结果:最终纳入42项研究,包括3项SR/Meta分析和39项RCT;共8275例患者;涉及环磷腺苷、环磷腺苷葡胺及二丁酰环磷腺苷钙3种环磷腺苷类药物;涉及心力衰竭、心肌梗死、心肌炎、心绞痛及银屑病5种疾病类型。研究结果显示,上述3种环磷腺苷类药物对于心肌梗死、心肌炎、心绞痛均有良好的治疗效果,其中二丁酰环磷腺苷钙因其特殊的化学结构,对银屑病的治疗具有一定的优势。安全性方面,环磷腺苷类药物整体安全性良好,均在可控范围。结论:环磷腺苷类药物可有效治疗心肌梗死、心肌炎、心绞痛,安全性良好,其中二丁酰环磷腺苷钙对银屑病的治疗具有一定的优势。

OBJECTIVE:To systematically evaluate the efficacy and safety of cyclic adenosine monophosphate related drugs.METHODS:PubMed,Embase,the Cochrane Library,CNKI,Wanfang Data and CBM were retrieved to collect the systematic reviews(SR)/Meta-analyses and randomized controlled trials(RCT)of cyclic adenosine monophosphate related drugs published in the core journals of Chinese scientific and technical papers from the establishment of the database to Jan.2024,and the English database was not restricted by journals.The included literature was summarized and concluded using descriptive analysis.RESULTS:A total of 42 studies were enrolled,including 3 SR/Meta-analyses and 39 RCT.Totally 8275 patients were involved in three kinds of cyclic adenosine monophosphate related drugs,including cyclic adenosine monophospholide,meglumine adenosine cyclophosphate and dibutyrylcalcium adenosine cyclophosphate,with 5 types of diseases,including heart failure,myocardial infarction,myocarditis,angina pectoris and psoriasis.Results showed that three kinds of cyclic adenosine monophosphate related drugs had significant therapeutic effects on myocardial infarction,myocarditis and angina pectoris,among which calcium dibutyryl cyclic adenosine phosphate had certain advantages in the treatment of psoriasis due to its special chemical structure.In terms of safety,the overall safety of cyclic adenosine monophosphate related drugs was favorable,which were within the controllable range.CONCLUSIONS:Cyclic adenosine monophosphate related drugs are effective in the treatment of myocardial infarction,myocarditis,and angina pectoris with higher safety,and calcium dibutyryl cyclic adenosine phosphate has certain advantages in the treatment of psoriasis.