咪唑斯汀联合H2受体拮抗药治疗慢性荨麻疹疗效与安全性的Meta分析Δ

摘要

OBJECTIVE:To systematically review the efficacy and safety of mizolastine combined with H2 recepter antagonists in the treatment of chronic urticaria,and provide evidence-based reference for the clinical treatment. METHODS:Retrieved from PubMed,Cochrane Library,EMBase,CBM,CJFD,etc.,randomized controlled trials (RCT) or QRCT about mizolastine com-bined with H2 recepter antagonists(test group)versus mizolastine alone(control group)in the treatment of chronic urticaria. After quality evaluation and data extract,Meta-analysis was conducted by using Stata 12.0 statistics software. RESULTS:A total of 12 RCT were included,involving 1 188 patients. Results of Meta-analysis showed the effective rate [RR=1.23,95%CI(1.16,1.31), P<0.001] in test group was significantly higher than control group,subgroup analysis showed the the efficacies of different combi-nation of mizolastine and other drugs were significantly better than control group;there was no significant difference in the inci-dence of adverse reactions between 2 group[RR=1.01,95%CI(0.71,1.44),P>0.05]. CONCLUSIONS:The effective rate of mizo-lastine combined with H2 recepter antagonists is significantly higher than mizolastine in the treatment of chronic urticaria,with bet-ter safety. Due to the limit of methodological quality and sample size,it remains to be further verified with more rigorously de-signed and long-term follow-up of large-scale RCT.%目的：系统评价咪唑斯汀联合H2受体拮抗药治疗慢性荨麻疹的疗效与安全性，以为临床治疗提供循证参考。方法：计算机检索PubMed、Cochrane图书馆、EMBase、中国生物医学文献数据库、中国期刊全文数据库等，收集咪唑斯汀联合H2受体拮抗药（试验组）对比单用咪唑斯汀（对照组）治疗慢性荨麻疹的随机对照试验（RCT）或半随机对照试验，对符合标准的临床研究进行资料提取和质量评价后，采用Stata 12.0统计软件进行Meta分析。结果：共纳入12项RCT，合计1188例患者。Meta分析结果显示，试验组患者总有效率[RR＝1.23，95％CI（1.16，1.31），P＜0.001]显著高于对照组，且亚组分析表明咪唑斯汀联合不同H2受体拮抗药的疗效均显著优于对照组，差异均有统计学意义；不良反应发生率与对照组比较差异无统计学意义[RR＝1.01，95％CI（0.71，1.44），P＞0.05]。结论：咪唑斯汀联合H2受体拮抗药治疗慢性荨麻疹的疗效优于单用咪唑斯汀，且安全性相当。受纳入研究方法学质量和样本量限制，该结论有待更多设计严格、长期随访的大样本RCT加以验证。