目的 了解2007年-2008年成都地区17家医院消化系统药物的使用状况。 方法 采用限定日剂量（DDD）的方法，对成都地区2007年-2008年17家医院消化系统用药的销售金额、用药频度（DDDs）等进行统计分析。 结果 2007-2008年成都地区17家医院消化系统用药总金额分别为12 527.89万元和16 446.21万元，居所有药物销售总额的第5位。在金额排序和用药频度排序中，抗溃疡药、肝病用药居于前列。 结论 消化系统药物的应用状态与同期的整体增长保持一致，相比上一年略有上涨。抗溃疡药中的质子泵抑制剂以其优异的性价比，引领着消化系统药物销售额的增长。
Objective To assess the effectiveness and safety of cyclosporine A (CsA) for aplastic anemia (AA) in China. Methods Randomized controlled trails (RCTs) of CsA for AA were collected from CBMdisc (1978 to 2008), CNKI (1979 to 2008), and VIP (1989 to 2008). Other relevant journals were also hand searched. The methodological quality of included studies was evaluated, and data analyses were performed with The Cochrane Collaboration’s software RevMan 4.2.0. Results A total of 19 RCTs were included. As for the total effective rate and complete remission rate, significant differences were noted between CsA + androgen vs. androgen alone, CsA + androgen combination vs. androgen combination, as well as CsA + androgen + other drugs vs. androgen + other drugs [total effective rate: RRs and 95%CIs were 1.48 (1.28 to 1.70), 1.67 (1.17 to 2.39), and 1.51 (1.09 to 2.08); complete remission rate: RRs and 95%CIs were 2.06 (1.33 to 3.19), 3.52 (1.19 to 10.39), and 1.54 (1.00 to 2.38)]. Conclusion According to the domestic evidence, treatment with CsA for AA may improve the total effective rate and complete remission rate. However, more high quality clinical trials are expected for further study.
【摘要】 目的 采用循证医学的方法评价硫唑嘌呤（aiathioprine，AZA）治疗溃疡性结肠炎（ulcerative colitis，UC）的有效性和安全性。 方法 计算机检索PubMed、Cochrane library、Embase、CNKI、维普和CBM数据库收集国内外关于AZA诊疗UC的随机对照试验（ramdomized controllel trial，RCT）。按Cochrane系统评价的方法评价纳入研究质量，并进行Meta分析。 结果 共纳入5个RCT，共262例UC患者。Meta分析结果显示，AZA治疗UC在缓解率方面与安慰剂比较，差异无统计学意义[P=1.19，95%CI（0.94，1.49），P=0.14]；在复发率方面，两者比较差异有统计学意义[P=0.72，95%CI（0.54，0.95），P=0.02]；全部不良反应方面和严重不良反应方面，两者比较差异无统计学意义，Meta分析结果分别为[P=2.52，95%CI（0.82，7.74），P=0.11]和[P=4.03，95%CI（0.88，18.53），P=0.07]。 结论 系统评价结果为AZA在疗效方面优于安慰剂，在不良反应发生率方面差异无统计学意义。但由于纳入的5个研究中没有高质量的RCT，且有1个可能产生高度偏倚，使得这一结论受到影响，有必要开展更多设计严谨，大样本、多中心的RCT。【Abstract】 Objective To assess the efficacy and safety of azathio-prine in the treatment of ulcerative colitis through an evidence-based method. Methods We searched the literature from databases like PubMed, Cochrane library, CNKI, VIP, and CBM, and evaluated the quality of studies according to Cochrane systematic review. Finally, Meta-analysis was performed. Results Five randomized controlled trials (RCT) were included in this study with a total of 262 patients. Meta-analysis showed that there was no significant difference in the rate of remission between azathio-prine and placebo in treating ulcerative colitis [P=1.19, 95%CI (0.94, 1.49),P=0.14]. There was significant difference in the relapse rate between the two treating methods [P=0.72, 95%CI (0.54, 0.95),P=0.02]. In addition, there was no statistical difference in all adverse effects [P=2.52, 95%CI (0.82, 7.74),P=0.11] and serious adverse effects [P=4.03, 95%CI (0.88, 18.53),P=0.07] between the two treating methods. Conclusion In the treatment of ulcerative colitis, azathio-prine has a significant advantage in efficacy than placebo, but there is no significant difference in the rate of adverse events between the two groups. However, none of the 5 RCT included in this review has a high quality and one of them even probably has a high bias, which has a big influence on our conclusion. Consequently, multi-center large-scale randomized controlled trials of higher quality are needed to make confirmation.
目的 评价卡培他滨+伊立替康与氟尿嘧啶/醛氢叶酸（5-FU/LV）+伊立替康治疗转移性结直肠癌的有效性和安全性。 方法 计算机检索PubMed、CENTRAL、Embase、中国生物医学数据库、中国期刊全文数据库、维普数据库和万方数据库，检索时间均从建库至2011年9月。对符合纳入标准的随机对照试验进行质量评价和Meta分析。 结果 纳入3个随机对照试验，共计419例患者，卡培他滨+伊立替康在中位生存期、完全缓解率[RR=1.58，95%CI（0.27，9.11），P=0.61]、部分缓解率[RR=0.86，95%CI（0.68，1.09），P=0.20]、总有效率[RR=0.88，95%CI（0.71，1.09），P=0.26]上表现出与5-FU/LV+伊立替康相似的效果，安全性方面卡培他滨+伊立替康有较高的Ⅲ/Ⅳ级恶心[RR=1.92，95%CI（1.05，3.54），P=0.04]、腹泻[RR=3.23，95%CI（2.14，4.89），P＜0.000 01]发生风险和较低的Ⅲ/Ⅳ级中性粒细胞减少[RR=0.72，95%CI（0.53，0.98），P=0.04]发生风险。 结论 根据当前现有证据，5-FU/LV+伊立替康可能较卡培他滨+伊立替康更为有利于转移性结直肠癌患者的治疗，但仍需结合临床实际情况进行化疗方案的优选。
【摘要】 目的 系统评价司帕沙星对比氧氟沙星治疗耐多药肺结核的有效性和安全性。 方法 计算机检索Cochrane图书馆临床对照试验资料库（2010年第2期）和PubMed（1978年-2010年10月）、EMBASE（1974年-2010年10月）、中国学术期刊网络出版总库（1978年-2010年10月）、维普（1989年-2010年10月）、中国生物医学文献数据库（1978年-2010年10月）；手工检索其他相关杂志。检索语种为中文和英文。纳入司帕沙星对比氧氟沙星治疗耐多药肺结核的随机对照试验。按Cochrane系统评价的方法评价纳入研究质量，用RevMan 5.0软件对数据进行Meta分析。 结果 共纳入8篇研究，Meta分析结果显示司帕沙星组与氧氟沙星组相比，痰菌转阴率、病灶显著吸收率、空洞闭合率均高于对照组，差异具有统计学意义（Plt;0.05）。 结论 现有的证据表明，司帕沙星与其他抗结核药物联用治疗难治、耐多药肺结核的疗效优于氧氟沙星的联用方案，但由于纳入的文献数量有限，质量参差不齐，存在潜在的发表偏倚。【Abstract】 Objective To assess the clinical efficacy and safety of sparfloxacin versus ofloxacin in treatment of multi-drug resistant pulmonary tuberculosis (MDR-TB). Methods Literatures were retrieved from PubMed (1978-October, 2010), EMBASE (1974-October 2010), Cochrane library (2nd volume, 2010), China Academic Journal Network Publishing Database (1978-October, 2010), VIP (1989-October, 2010) and CBM (1978 to October, 2010) by computer, and searched some other relevant journals manually. Chinese and English were both used in the search. Randomized controlled trials (RCTs) on sparfloxacin versus ofloxacin in treating pulmonary tuberculosis were included in this study. Meta-analysis was conducted by RevMan 5.0 software. Results The meta-analysis of 8 included RCTs showed that the sputum negative conversion rate, focus absorption rate, cavity closure rate in the sparfloxacin group were significantly higher than the ofloxacin group (P＜0.05). Conclusions The analysis indicates that combined treatment with sparfloxacin has a better effect in treating MDR-TB than with ofloxacin. However, the reliability of this review may be affected by the number and quality of studies included. Large-scale randomized controlled trials of high quality are needed to confirm the conclusions above.
Objective To evaluate the efficacy and safety of low-dose versus standard-dose cyclosporine immunosuppressive therapy in kidney transplant recipients. Methods We searched MEDLINE, EMbase, SCI, CBM and The Cochrane Library from the establishment to December 2009 to screen randomized controlled trials (RCTs) of low-dose versus standard-dose cyclosporine immunosuppressive therapy in kidney transplant recipients. Quality assessment and meta-analyses were performed for the included studies. Results A total of 6 RCTs involving 1551 patients were identified, among which 4 RCTs were graded A and two were graded B. The meta-analyses indicated that there were no significant differences between the two groups at the end of 6-month and 12-month follow-up in the acute rejection rate at a RR 1.07, 95%CI 0.69 to 1.65 and a RR 1.06, 95%CI 0.71 to 1.57, respectively. There were no significant differences between the two groups at the end of 6-month and 12-month follow-up in the patients’ death rate at a RR 0.64, 95%CI 0.20 to 2.03 and a RR 0.61, 95%CI 0.30 to 1.24, respectively. There were no significant differences between the two groups in renal function and safety. Conclusion Based on the current evidence, compared with standard-dose CsA, low-dose CsA has the same effect and safety for the short-term results, but the long-term results need to be further studied.
【摘要】 目的 评价肾移植术后他克莫司（TAC）低剂量对比常规剂量干预的疗效和安全性。 方法 检索MEDLINE、EMbase、SCI、CBM、Cochrane图书馆，纳入肾移植术后TAC低剂量对比常规剂量免疫抑制治疗的随机对照试验（RCT）。检索时间从各个数据库建库至2009年12月，对纳入研究进行方法学质量评价和Meta分析。 结果 纳入3个RCT，其中A级研究2个，B级研究1个。分析结果显示:两组急性排斥反应发生率比较，无统计学意义[RR=1.39， 95%CI(0.64， 3.01)]；肾小球滤过率、受者/移植物生存率和纳入分析的安全性指标差异均无统计学意义。 结论 基于当前临床证据，肾移植术后TAC低剂量与常规剂量干预相比，近期疗效和安全性相似；远期结果尚需进一步研究探讨。【Abstract】 Objective To evaluate the effect and safety of low-dose versus standard-dose tacrolimus immunosuppressive therapy on kidney transplant recipients. Methods MEDLINE, EMbase, SCI, CBM and the Cochrane library were searched and randomized controlled trials (RCT) of low-dose versus standard-dose tacrolimus immunosuppressive therapy in kidney transplant recipients were gathered. The search was updated in December 2009. Quality assessment and meta-analysis were performed. Results A total of three RCT were identified, two of which were graded A and one was graded B. The analysis results indicated that RR (95%CI) value of the acute rejection rate was 1.39 (0.64, 3.01); glomerular filtration rate, patient/graft survival rate, and safety analysis were not significant different between the two groups. Conclusion Based on the evidence currently, compared to standard-dose TAC, Low-dose TAC has the same effect and safety results, but further study are needed to get the long term results.
【摘要】 目的 探讨二甲双胍致不良反应的一般规律和特点。 方法 检索1994年-2011年中国期刊全文数据库中二甲双胍所致不良反应个案报道的文献，得到符合条件的文献29篇共33例，进行统计分析。 结果 33例不良反应主要表现为内分泌系统（48.5%），皮肤及附件（18.2%），变态反应（15.2%），消化系统（9.1%），神经系统（6.1%）等。 结论 临床上应重视二甲双胍引起的不良反应，用药时应加强对患者的监护，以减少严重药物不良反应的发生。【Abstract】 Objective To investigate the characteristics and the general pattern of the adverse drug reactions (ADR) induced by metformin. Methods The ADR induced by metformin reported in domestic medical journals during 1994-2008 were retrieved by means of CNKI. A total of 29 related literatures involving 33 cases, and a related database was established for statistical analysis. Results The main clinical manifestation represented as endocrine system (48.5%), lesion of skin and its appendants (18.2%), allergic reactions (15.2%), digestive system (9.1%), nervous system (6.1%) and so on. Conclusion It is necessary to pay attention to ADR induced by metformin and strengthen observation during medication in order to reduce serious ADR.
【摘要】 目的 探讨非诺贝特致药品不良反应（ADRs）的一般规律和特点。 方法 检索PubMed（1978年-2009年8月）、中国期刊全文数据库CNKI（1980年-2009年8月）、中国生物医学文献数据库CBMDise（1980年-2009年8月）非诺贝特所致ADRs文献，进行统计、分析。 结果 非诺贝特致ADRs多发生在gt;40岁年龄段，与性别无显著关联；64例ADRs主要涉及骨骼肌肉系统、消化系统、泌尿生殖系统、过敏反应，及时处理者预后良好。 结论 临床上应重视非诺贝特所致ADRs，及时处理。【Abstract】 Objective To analyse the clinical features, correlation factors, preventions and cures of (adverse drug reactions, ADRs) caused by fenofibrate. Methods The cases of ADRs caused by fenofibrate were collected and analyzed from Pubmed (1978 - August 2009), CNKI (1980 - August 2009) and CBMDise (1980 - August 2009). Results Fenofibrate-induced ADRs were mostly seen in patients over 40 years old, but which was independent for sex. Totally, 64 ADRs were involved in the skeletal musculature system, digestive system, urinogenital system, and allergic response. The prognosis was favorable. Conclusion More attention should be given to patients with fenofibrate and ADRs should be treated as soon as possibile.
Objective To assess the effectiveness and safety of Tongxinluo Capsule in the treatment of vertebrobasilar artery insufficiency. Methods The Cochrane Library, MEDLINE, VIP and CNKI were searched. Two authors independently collected data, including randomized controlled trials that met the inclusion criteria. They evaluated the quality of these trials and performed meta-analysis using The Cochrane Collaboration’s RevMan 5.0. Results Eleven studies involving 1157 participants were included. All the included studies were inadequate at reporting randomization, concealment of allocation and blinding. Meta-analysis based on the included studies showed that Tongxinluo Capsule with Danshen was better than Danshen alone in vertebrobasilar artery insufficiency (RR= 1.35, 95%CI 1.24 to 1.48) and blood flow velocity of vertebrobasilar artery (WMD=3.60, 95%CI 2.44 to 4.77 and WMD=3.46, 95%CI 1.89 to 5.04). Tongxinluo Capsule with simple basic therapy was better than simple basic therapy alone in vertebrobasilar artery insufficiency (RR=1.21, 95%CI 1.11 to 1.31) and blood flow velocity of vertebrobasilar artery (WMD=3.85, 95%CI 2.19 to 5.51). Conclusion Tongxinluo Capsule is an effective and safe drug for vertebrobasilar artery insufficiency. However, due to the limited quantity and quality of the included studies, we can not draw a firm conclusion about the effectiveness of Tongxinluo Capsule compared to the simple basic therapy or Danshen. The results suggest that further and larger-scale trials using Tongxinluo Capsule for vertebrobasilar artery insufficiency are needed.