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[摘要]
目的 系统评价沙利度胺联合其他药品治疗类风湿关节炎的有效性与安全性。方法 检索2017年9月1日前发表在PubMed、Medline、Web of Science及中国知网(CNKI)、中国生物医学文献数据库(CBM)、维普数据库(VIP)、万方数据库中相关的随机对照试验(RCTs),应用State 14.0软件进行Meta-分析。结果 共纳入15篇相关文献,累计1 246例患者。Meta-分析结果显示,联用沙利度胺组在有效率(OR=2.71,95% CI=1.87~3.93,P<0.05)、关节肿胀数(OR=1.68,95% CI=0.99~2.37,P<0.05)、关节压痛数(OR=2.22,95% CI=1.31~3.14,P<0.05)、红细胞沉降率(OR=12.93,95% CI=10.26~15.60,P<0.05)等方面疗效均优于对照组。在不良反应发生率方面,联用沙利度胺组与对照组比较无显著性差异(OR=0.93,95% CI=0.66~1.32,P>0.05)。结论 联用沙利度胺在类风湿关节炎的治疗中有积极作用。
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[Abstract]
Objective To systematically review the efficiency and safety of thalidomide combined with other drugs in the treatment of rheumatoid arthritis. Methods The randomized controlled trials (RCTs) about thalidomide treating rheumatoid arthritis were retrieved in the database of PubMed, Medline Web of science, CNKI, VIP, CBM, and Wanfang Data from the date of database foundation to August 2017. Meta-analysis was performed with state14.0 software. Results A total of 15 RCTs involving 1 246 patients were finally included; Meta-analysis results showed that, the effect of thalidomide combined with control was superior to control alone in the effective rate (OR=2.71, 95% CI=1.87-3.93, P<0.05), joint swelling number (OR=1.68, 95% CI=0.99-2.37, P<0.05), joint tenderness number(OR=2.22, 95% CI=1.31-3.14, P<0.05), and erythrocyte sedimentation rate (OR=12.93, 95% CI=10.26-15.60, P<0.05). There was no significant difference in the occurrence of adverse events between the thalidomide group and control group (OR=0.93, 95% CI=0.66-1.32, P>0.05). Conclusion Thalidomide combined with other drugs has a positive effect on the treatment of rheumatoid arthritis.
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[基金项目]
辽宁省科学技术计划项目(2014226033)