酚妥拉明联合垂体后叶素治疗支气管扩张咯血的系统评价

摘要

Objective To systematically review the effectiveness and safety of phentolamine combined with pituitrin versus phentolamine alone in the treatment of bronchiectasis hemoptysis. Methods Databases including PubMed、EMbase, The Cochrane Library ( Issue 11, 2014 ) , CNKI, WanFang Data and VIP were electronically searched from inception to October 2014, for the randomized controlled trials ( RCT ) on phentolamine combined with pituitrin versus phentolamine alone in the treatment of bronchiectasis hemoptysis. Meta-analysis was performed using RevMan 5. 2. 3 software. Results 14 RCTs were included. The results of meta-analysis indicated that phento-lamine combined with pituitrin versus phentolamine alone can significantly increase the efficiency rate [ RR=1. 24, 95% CI(1. 11, 1. 40), P=0. 000 3 ] and the effective rate [ RR=1. 36, 95% CI(1. 16, 1. 60), P=0. 000 1 ] , reduce the incidence of invalid rate [ RR=0. 31, 95% CI(0. 22, 0. 44), P ﹤ 0. 000 01 ] , shorten the hemoptysis stopping or remission time [ MD= -2. 01, 95% CI(-2. 32,-1. 70), P ﹤ 0. 000 01 ];phentolamine combined with pituitrin versus phentolamine alone can not increase the incidence rate of chest tightness [ RR=1. 25, 95% CI(0. 34, 4. 59), P=0. 74 ] and dizziness [ RR=0. 25, 95% CI(0. 03, 2. 18), P=0. 21 ] . Conclusion Phento-lamine combined with pituitrin versus phentolamine alone can significantly increase the rate of efficiency and effectivity, ruduce the in-cidence of invalid rate, shorten the hemoptysis stopping or remission time, and will not increase the incidence rate of chest tightness and dizziness.%目的：系统评价酚妥拉明联合垂体后叶素治疗支气管扩张咯血的疗效及安全性。方法计算机检索PubMed，EMbase，The Cochrane Library（2014年第11期），CNKI，WanFang Data和VIP数据库，截至2014年10月，纳入酚妥拉明联合垂体后叶素对比单用酚妥拉明治疗支气管扩张咯血的相关随机对照试验（RCT），采用RevMan 5.2.3软件进行Meta分析。结果共纳入14个RCT，Meta分析结果显示，酚妥拉明联合垂体后叶素对比酚妥拉明能提高显效率[ RR=1.24，95% CI（1.11，1.40），P=0.0003]和有效率[ RR=1.36，95% CI （1.16，1.60），P=0.0001]，降低无效率[ RR=0.31，95% CI（0.22，0.44），P﹤0.00001]，缩短咯血停止或缓解时间[ MD=－2.01，95% CI（－2.32，－1.70），P﹤0.00001]。且未增加胸闷[ RR=1.25，95% CI（0.34，4.59），P=0.74]、头晕[ RR=0.25，95% CI（0.03，2.18），P=0.21]的发生率。结论酚妥拉明联合垂体后叶素较单用酚妥拉明，安全性无明显差异，但疗效更佳。