小剂量与常规剂量秋水仙碱治疗急性痛风性关节炎的系统评价

中国临床药理学与治疗学 ›› 2014, Vol. 19 ›› Issue (6): 656-662.

小剂量与常规剂量秋水仙碱治疗急性痛风性关节炎的系统评价

蒙龙¹, 李娟¹, 龙锐¹, 贾运涛²

¹重庆医科大学附属第一医院药学部, 重庆 400016;
²重庆医科大学附属儿童医院药剂科, 重庆 400014

收稿日期:2013-10-24 修回日期:2014-06-06 发布日期:2014-07-01
通讯作者: 贾运涛, 副主任药师, 研究方向:临床药学、药代动力学。Tel: 023-63625666 E-mail: jiayuntaomail@tom.com
作者简介:蒙龙, 男, 硕士, 药师, 研究方向:临床药学。Tel: 023-89012401 E-mail: cpu0641022@sina.com

A systematic review of low-dose and routine-dose colchicine regimen in the treatment of acute gout flare

MENG Long¹, LI Juan¹, LONG Rui¹, JIA Yun-tao²

¹Department of Pharmacy, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China;
²Department of Pharmacy, Childrens Hospital of Chongqing Medical University, Chongqing 400014, China

Received:2013-10-24 Revised:2014-06-06 Published:2014-07-01

摘要/Abstract

摘要： 目的: 通过Meta分析比较小剂量与常规剂量秋水仙碱治疗痛风急性发作的疗效和安全性。方法: 在Medline、Sciencedirect、CNKI、万方数据库系统搜索相关文献。采用RevMan5 软件对其行统计分析。结果: 总计11篇随机对照试验被纳入分析。Meta分析发现小剂量秋水仙碱与常规剂量秋水仙碱两种治疗方案在关节疼痛评分减少≥2分的比例(RR 1.04, 0.95%CI 0.77～1.40, P=0.81)、疼痛缓解率(RR 1.06, 95%CI 0.85～1.31, P=0.62)和临床有效率(RR 0.89, 95% CI 0.71～1.11, P=0.29)均没有统计学差异。但是小剂量秋水仙碱方案的胃肠道不良反应率(RR 0.25, 95% CI 0.19～0.34, P<0.000 01)和总不良反应发生率(RR 0.36, 95% CI 0.26～0.50, P<0.000 01)显著降低。小剂量秋水仙碱+非甾体抗炎药治疗方案相对于常规剂量秋水仙碱治疗方案临床有效率没有统计学差异(RR 1.46, 95% CI 0.42～5.08, P=0.55);但是小剂量秋水仙碱+非甾体抗炎药治疗方案的不良反应导致停药率(RR 0.14, 95% CI 0.07～0.28, P<0.000 01)、总不良反应发生率(RR 0.16, 95% CI 0.08～0.29, P<0.000 01)和胃肠道不良反应率(RR 0.17, 95% CI 0.11～0.27, P<0.000 01)显著降低。结论: 常规剂量秋水仙碱治疗组相对于小剂量秋水仙碱治疗组疗效没有统计学差异, 且发生不良反应风险更高。

关键词: 秋水仙碱, 剂量, 疗效, 安全性, 痛风

Abstract: AIM : To investigate the efficacy and safety of low-dose colchicine regimen compared with routine-dose colchicines for acute gout flare.METHODS: We searched MEDLINE, Sciencedirect, CNKI and WanFang database systematically. RevMan5 was used for meta-analysis.RESULTS:A total of 11 randomized controlled trials matched our inclusion and exclusion criteria. Meta-analysis found that low-dose colchicine regimen showed no significant difference compared with routine-dose colchicine regimen in the proportion of at least a 2-unit reduction in target joint pain score(RR 1.04, 0.95%CI 0.77-1.40, P=0.81), proportion of pain relief(RR 1.06, 95%CI 0.85-1.31, P=0.62) and proportion of clinical efficacy(RR 0.89, 95% CI 0.71-1.11, P=0.29). In addition, gastrointestinal adverse reaction(RR 0.25, 95% CI 0.19-0.34, P<0.000 01) and overall adverse reaction rate(RR 0.36, 95% CI 0.26-0.50, P<0.000 01) were lower in low-dose colchicine group. Similarly, there was no significant difference concerning clinical efficacy rate(RR 1.46, 95% CI 0.42-5.08, P=0.55)between low-dose colchicines + non-steroid anti-inflammtory drugs group compared with routine-dose colchicine group. However, fewer patients experienced overall adverse reaction(RR 0.16, 95% CI 0.08-0.29, P<0.000 01), withdrawal due to adverse reaction(RR 0.14, 95% CI 0.07-0.28, P<0.00001)and gastrointestinal adverse reaction(RR 0.17, 95% CI 0.11-0.27, P<0.000 01)in low-dose colchicines + non-steroid anti-inflammtory drugs group.CONCLUSION: Our meta-analysis indicated that routine-dose colchicine regimen showed no significant superior to low-dose colchicine regimen, and routine-dose colchicine regimen increased the risk of adverse reaction significantly.

Key words: colchicine, dosage, efficacy, safety, gout

中图分类号:

R311

蒙龙, 李娟, 龙锐, 贾运涛. 小剂量与常规剂量秋水仙碱治疗急性痛风性关节炎的系统评价[J]. 中国临床药理学与治疗学, 2014, 19(6): 656-662.

MENG Long, LI Juan, LONG Rui, JIA Yun-tao. A systematic review of low-dose and routine-dose colchicine regimen in the treatment of acute gout flare[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2014, 19(6): 656-662.

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