伐昔洛韦对比阿昔洛韦治疗带状疱疹疗效和安全性的Meta分析

摘要

OBJECTIVE:To evaluate therapeutic efficacy and safety of valaciclovir versus acyclovir in the treatment of herpes zoster,and to provide evidence-based reference in clinic.METHODS:Retrieved from PubMed,Medline,CJFD,VIP and Wanfang Database,randomized controlled trials (RCTs) about valaciclovir (trial group) versus acyclovir (control group) in the treatment of herpes zoster were included.The data was analyzed statistically by using Rev Man 5.3 software after data extraction and quality evaluation by Cochrane systematic reviewer manual 5.1.0.RESULTS:A total of 12 RCTs were included,involving 1 059 patients.The result of Meta-analysis showed that:total response rate [OR =4.64,95 ％ CI (2.99,7.20),P＜ 0.001] and cure rate [OR =2.93,95％CI(2.13,4.03),P＜0.001] of trial group were significantly higher than those of control group;the incidence of postherpetic neuralgia in trial group [OR=0.39,95％CI(0.22,0.69),P=0.001] was significantly lower than control group,with statistical significance.There was no statistical significance in the incidence of ADR between 2 groups [OR=0.79,95％CI(0.49,1.29),P=0.35].CONCLUSIONS:Therapeutic efficacy of valaciclovir is better than that of acyclovir in the treatment of herpes zoster,can significantly reduce the incidence of postherpetic neuralgia.Both have similar safety.%目的:系统评价伐昔洛韦对比阿昔洛韦治疗带状疱疹的疗效和安全性,为临床提供循证参考.方法:计算机检索PubMed、Medline、中文科技期刊数据库、中国期刊全文数据库和万方数据库,纳入伐昔洛韦(试验组)对比阿昔洛韦(对照组)治疗带状疱疹的随机对照试验(RCT),按照Cochrane系统评价员手册5.1.0评价纳入研究的质量并提取资料后,采用Rev Man 5.3统计软件进行Meta分析.结果:共纳入12项RCT,合计1 059例患者.Meta分析结果显示,试验组患者总有效率[OR=4.64,95％CI(2.99,7.20),P＜0.001]和治愈率[OR=2.93,95％CI(2.13,4.03),P＜0.001]均显著高于对照组,后遗神经痛发生率[OR=0.39,95％CI(0.22,0.69),P=0.001]显著低于对照组,差异均有统计学意义.两组患者不良反应发生率比较,差异无统计学意义[OR=0.79,95％CI(0.49,1.29),P=0.35].结论:伐昔洛韦治疗带状疱疹疗效优于阿昔洛韦,可明显降低患者后遗神经痛发生率,两者安全性相当.