目的:系统评价阿苯达唑治疗囊型棘球蚴病的疗效,为临床提供循证参考。方法:计算机检索PubMed、EMBase、Cochrane图书馆、中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊数据库和万方数据库,收集阿苯达唑单药或联合其他阳性药物/外科手术治疗囊型棘球蚴病的随机对照试验(RCT),对符合纳入标准的研究提取资料并按照Cochrane协作网提供的偏倚风险评价工具 5.1.0进行质量评价,采用Rev Man 5.3统计软件进行Meta分析。结果:共纳入11项RCT,合计1 020例患者。Meta分析结果显示,阿苯达唑单药治疗囊型棘球蚴病可以显著提高有效率[RR=4.08,95%CI(1.82,9.14),P<0.001];阿苯达唑联合其他阳性药物的有效率显著高于阳性药物单用[RR=1.28,95%CI(1.01,1.63),P=0.04];阿苯达唑联合外科手术治疗的有效率显著高于单纯外科手术治疗[RR=1.22,95%CI(1.10,1.35),P<0.001],差异均有统计学意义。结论:阿苯达唑单药或联合其他阳性药物/外科手术治疗囊型棘球蚴病疗效均较好。
Abstract
OBJECTIVE: To systematically review therapeutic efficacy of albendazole in the treatment of cystic echinococcosis, and to provide evidence-based reference for clinic treatment. METHODS: Retrieved from PubMed, EMBase, Cochrane library, CBM, CJFD, VIP and Wanfang database, randomized controlled trails(RCTs) about albendazole alone or combined with other positive drugs/surgery in the treatment of cystic echinococcosis were collected. Meta-analysis was performed by using Rev Man 5.3 software after data extraction and quality evaluation according to Cochrane bias risk evaluation tool 5.1.0. RESULTS: A total of 11 RCTs were enrolled, involving 1 020 patients. Results of Meta-analysis showed the response rate of albendazole alone was significantly higher than that of placebo in the treatment of cystic echinococcosis [RR=4.08,95%CI(1.82,9.14),P<0.001]; response rate of albendazole+other positive drugs was significantly higher than that of positive drug alone in the treatment of cystic echinococcosis [RR=1.28,95%CI(1.01,1.63),P=0.04]; response rate of albendazole+surgery was significantly higher that that of surgery alone in the [RR=1.22,95%CI(1.10,1.35),P<0.001]; there was statistical significance. CONCLUSIONS: Both albendazole alone or combined with other positive drugs/surgery show good therapeutic efficacy in the treatment of cystic echinococcosis.