作　　者： ;

机构地区： 广州医科大学南山学院

出　　处： 《国际呼吸杂志》 2019年第14期1078-1085,共8页

摘　　要： 目的 系统评价孟鲁司特(MONT)联合布地奈德(BUN)治疗嗜酸粒细胞性支气管炎(EB)的有效性及安全性.方法 系统检索PubMed、Cochrane Library、EMBase、中国期刊全文数据库、中文科技期刊全文数据库、中国生物医学文献数据库、万方数据库已公开发表的EB患者MONT联合BUN治疗的随机或非随机对照试验,检索时间跨度定为建库至2018年10月.对于符合纳入标准的研究采取Cochrane网(www.cochrane.org)的系统评价工具行质量评价,提取符合标准的文献中相关临床效应指标后使用RevMan 5.3.5统计软件行数据处理.结果 纳入13项研究,共1024例患者.Meta分析结果显示:联合用药组较BUN组可有效提高治疗效果和改善肺功能(P<0.001),明显降低复发率(P<0.001),降低痰嗜酸粒细胞(P=0.01)、外周血嗜酸粒细胞(P<0.001)和血清白细胞介素5(P<0.001)水平.2组不良反应发生率比较,差异无统计学意义(P=0.96).结论 MONT联合BUN治疗EB的临床有效率比单独吸入BU N高,且不增加不良反应的发生率,但由于纳入文献质量有限及总体样本量小,仍然需要开展更多的高质量、多中心、大样本的随机对照试验加以进一步验证. Objective To systematically assess the efficacy and safety of Montelukast (MONT) combined with budesonide (BUN) in the treatment of eosinophilic bronchitis ( EB) . Methods A systematic search was performed in databases included PubMed ,Cochrane Library , EMBase ,CNKI ,VIP ,CBM and Wan Fang from established to October , 2018 ,to find the clinical random controlled trials of MONT combined with BUN for EB .This study also used the assessment tools of the Cochrane collaboration to evaluate the quality of eligible literatures which have met the criterion ,and used RevMan 5 .3 .5 software for data processing .Results A total of 1024 patients from 13 studies were involved in this study .The results of the meta-analysis showed that the total effective rate of MONT combined with BUN group was higher ( P < 0 .001) ,thepulmonary function was significantly improved ( P <0 .001) ,and the recurrence rate was lower than that of the BUN group ( P <0 .001) ,compared with the BUN group .The levels of sputum eosinophil ( P =0 .01) ,peripheral blood eosinophils ( P <0 .001) ,fractional exhaled nitric oxide ( P <0 .001) and serum interleukin-5 ( P <0 .001) were significantly reduced .There was no significant difference in adverse reaction rate ( P =0 .96) .Conclusions The clinical efficacy about MONT combined with BUN treatment of EB is more obvious than that of use of BUN alone ,and the incidence of adverse reactions is not be significantly increased .However ,more high-quality ,multi-center ,large-scale randomized controlled trials are needed for further validation .

关 键 词： 布地奈德 分析 孟鲁司特 嗜酸粒细胞性支气管炎

领　　域： []