口服复方甘草酸苷联合常规疗法治疗皮炎湿疹疗效及安全性的Meta分析
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摘要
目的对口服复方甘草酸苷联合常规疗法治疗皮炎湿疹的疗效及安全性进行系统性分析。方法计算机检索Pubmed、Embase、Medline、Cochrane Library等英文数据库及CBM、CNKI、万方数字化期刊全文数据库及VIP中国科技期刊全文数据库等中文数据库,收集整理所有研究观察口服复方甘草酸苷治疗皮炎湿疹类皮肤病临床疗效的随机对照试验,检索的时间范围为各数据库建库至2018年5月。对检出文献进行筛选、采用RevMan5.3进行Meta分析。结果最终纳入14篇研究,所有临床研究均报道了口服复方甘草酸苷治疗皮炎湿疹疗效的计数资料,以总有效率=(痊愈率+显效率)作为疗效指标进行Meta分析,合并统计量OR值及95%CI为(OR=2.92,95%CI:2.22～3.86),(P<0.000 01)。不良反应发生率合并统计量OR值及95%CI为(OR=1.18,95%CI:0.61～2.27),(P=0.62)。根据联用药物的不同进行亚组分析,分为复方甘草酸苷单独联用外用药组及复方甘草酸苷同时联用外用药及抗组胺药组,总有效率亚组分析统计合并量分别为(OR=3.07,95%CI:1.93～4.88),(P<0.000 01);(OR=2.83,95%CI:1.90～4.19),(P<0.000 01);不良反应发生率亚组分析统计合并量分别为(OR=0.50,95%CI:0.12～2.08),(P=0.34);(OR=1.77,95%CI:0.78～4.01),(P=0.17)。结论本研究结果表明,口服复方甘草酸苷联合常规疗法治疗皮炎湿疹类皮肤病的疗效优于常规疗法,且未增加不良反应发生率。同时,复方甘草酸苷单独联用外用药与同时联用外用药及抗组胺药的疗效相当,且均未增加不良事件的发生。但此次研究因纳入的文献质量及数量的关系,有一定局限性,因此还需扩大样本量进行更深入的研究,以得出更为准确的结论。
Objective In order to evaluate the efficacy and safety of compound glycyrrhizin in combination with conventional therapy for eczema. Methods PubMed,Embase,Medline,Cochrane library,CBM,CNKI,CQVIP and Wanfang Data were searched from their respective inceptions to May 2018. Randomized controlled trials comparing compound glycyrrhizin plus conventional therapy to conventional therapy alone for eczema were included. Data analysis was performed using Review Manager 5.3. Results Fourteen randomized controlled trials were included. Compared with conventional therapy,addition of compound glycyrrhizin increased effective rate(OR=2.92,95%CI:2.22～3.86),(P<0.000 01),with not increasing the adverse events(OR =1.18,95% CI:0.61 ～2.27),(P =0.62). Compound glycyrrhizin plus topical corticosteroids alone,and the compound glycyrrhizin in conjunction with topical corticosteroids as well as antihistamine showed similar effects(OR =3.07,95%CI:1.93～4.88),(P<0.000 01) and(OR=2.83,95%CI:1.90～4.19),(P<0.000 01) respectively,and they all did not increase the adverse events(OR =0.50,95% CI:0.12 ～2.08),(P =0.34) and(OR =1.77,95% CI:0.78 ～4.01),(P =0.17).Conclusion Compound glycyrrhizin in conjunction with conventional therapy enhances clinical response,and does not increase any additional risk. Compound glycyrrhizin in conjunction with topical corticosteroids is as good as compound glycyrrhizin plus topical corticosteroids as well as antihistamine.
Objective In order to evaluate the efficacy and safety of compound glycyrrhizin in combination with conventional therapy for eczema. Methods PubMed,Embase,Medline,Cochrane library,CBM,CNKI,CQVIP and Wanfang Data were searched from their respective inceptions to May 2018. Randomized controlled trials comparing compound glycyrrhizin plus conventional therapy to conventional therapy alone for eczema were included. Data analysis was performed using Review Manager 5.3. Results Fourteen randomized controlled trials were included. Compared with conventional therapy,addition of compound glycyrrhizin increased effective rate(OR=2.92,95%CI:2.22～3.86),(P<0.000 01),with not increasing the adverse events(OR =1.18,95% CI:0.61 ～2.27),(P =0.62). Compound glycyrrhizin plus topical corticosteroids alone,and the compound glycyrrhizin in conjunction with topical corticosteroids as well as antihistamine showed similar effects(OR =3.07,95%CI:1.93～4.88),(P<0.000 01) and(OR=2.83,95%CI:1.90～4.19),(P<0.000 01) respectively,and they all did not increase the adverse events(OR =0.50,95% CI:0.12 ～2.08),(P =0.34) and(OR =1.77,95% CI:0.78 ～4.01),(P =0.17).Conclusion Compound glycyrrhizin in conjunction with conventional therapy enhances clinical response,and does not increase any additional risk. Compound glycyrrhizin in conjunction with topical corticosteroids is as good as compound glycyrrhizin plus topical corticosteroids as well as antihistamine.
引文
[1]张朝晖.复方甘草酸苷与西替利嗪胶囊联合治疗慢性湿疹临床疗效分析[J].医药论坛杂志,2016,37(11):149-150.
[2]寇长贵,冯晓飞.复方甘草酸苷治疗皮炎湿疹的疗效与安全性的meta分析[J].中国处方药,2016,14(2):1-4.
[3]韩素梅,张木仙,陈文峰.复方甘草酸苷片联合依巴斯汀治疗128例皮炎湿疹的临床疗效[J].中国实用医药,2016,11(2):147-148.
[4]黄卫东,蔡蕾,张善雳.复方甘草酸苷联合地氯雷他定治疗慢性湿疹52例疗效观察[J].福建医药杂志,2013,35(4):99,178.
[5]陈晓阳,简仁杰,郑森,等.盐酸左西替利嗪联合复方甘草酸苷治疗慢性湿疹的疗效观察[J].临床医学工程,2010,17(8):115-116.
[6]马颖,齐玮,刘敏池.复方甘草酸苷片联合派瑞松乳膏治疗湿疹疗效观察[J].河北医药,2010,32(15):2 065-2 066.
[7]李均.地奈德乳膏联合复方甘草酸苷片治疗湿疹的临床观察[J].北方药学,2015,12(6):58-59.
[8]毛太生,毛宁,吴婷婷,等.复方甘草酸苷联合盐酸左西替利嗪对皮炎湿疹患者Th1/Th2型细胞因子水平的影响[J].系统医学,2016,1(10):1-4.
[9]穆耶斯尔·纳斯尔.复方甘草酸苷片与复方氟米松软膏联合治疗湿疹的临床应用分析[J].中国保健营养,2017,6(17):351-352.
[10]刘旭星.复方氟米松软膏联合复方甘草酸苷治疗慢性湿疹的疗效观察[J].临床合理用药杂志,2011,4(11):97.
[11]宓聪藕,陈圣丽.复方甘草酸苷联合非索非那定片对慢性湿疹的临床疗效观察[J].健康研究,2015,35(2):161-163.
[12]吴学敬.复方甘草酸苷治疗慢性湿疹28例疗效观察[J].中国现代药物应用,2009,3(13):120-121.
[13]张文宪,原凡惠.复方甘草酸苷治疗慢性湿疹34例临床观察[J].中国现代药物应用,2010,4(5):98.
[14]李杰.联合用药治疗慢性湿疹的疗效分析[J].求医问药(下半月),2012,10(5):269.
[15]刘志刚,姜美英,曾敏帆,等.复方氟米松软膏和复方甘草酸苷片治疗皮炎湿疹临床疗效观察[J].江西医药,2009,44(9):908-910.
[16]杨俊.复方氟米松联合复方甘草酸苷治疗皮炎湿疹临床疗效观察[J].皮肤病与性病,2013,35(4):217+207.
[17]Diepgen TL,Andersen KE,Chosidow O,et al.Guidelines for diagnosis,prevention and treatment of hand eczema[J].J Dtsch Dermatol Ges,2015,13:e1-22.
[18]Jankowska-Konsur A,Reich A,Szepietowski JC.Systemic antihistamines--a common outside the guidelines therapeutic strategy in hand eczema management[J].J Eur Acad Dermatol Venereol,2016,30:67-71.
[2]寇长贵,冯晓飞.复方甘草酸苷治疗皮炎湿疹的疗效与安全性的meta分析[J].中国处方药,2016,14(2):1-4.
[3]韩素梅,张木仙,陈文峰.复方甘草酸苷片联合依巴斯汀治疗128例皮炎湿疹的临床疗效[J].中国实用医药,2016,11(2):147-148.
[4]黄卫东,蔡蕾,张善雳.复方甘草酸苷联合地氯雷他定治疗慢性湿疹52例疗效观察[J].福建医药杂志,2013,35(4):99,178.
[5]陈晓阳,简仁杰,郑森,等.盐酸左西替利嗪联合复方甘草酸苷治疗慢性湿疹的疗效观察[J].临床医学工程,2010,17(8):115-116.
[6]马颖,齐玮,刘敏池.复方甘草酸苷片联合派瑞松乳膏治疗湿疹疗效观察[J].河北医药,2010,32(15):2 065-2 066.
[7]李均.地奈德乳膏联合复方甘草酸苷片治疗湿疹的临床观察[J].北方药学,2015,12(6):58-59.
[8]毛太生,毛宁,吴婷婷,等.复方甘草酸苷联合盐酸左西替利嗪对皮炎湿疹患者Th1/Th2型细胞因子水平的影响[J].系统医学,2016,1(10):1-4.
[9]穆耶斯尔·纳斯尔.复方甘草酸苷片与复方氟米松软膏联合治疗湿疹的临床应用分析[J].中国保健营养,2017,6(17):351-352.
[10]刘旭星.复方氟米松软膏联合复方甘草酸苷治疗慢性湿疹的疗效观察[J].临床合理用药杂志,2011,4(11):97.
[11]宓聪藕,陈圣丽.复方甘草酸苷联合非索非那定片对慢性湿疹的临床疗效观察[J].健康研究,2015,35(2):161-163.
[12]吴学敬.复方甘草酸苷治疗慢性湿疹28例疗效观察[J].中国现代药物应用,2009,3(13):120-121.
[13]张文宪,原凡惠.复方甘草酸苷治疗慢性湿疹34例临床观察[J].中国现代药物应用,2010,4(5):98.
[14]李杰.联合用药治疗慢性湿疹的疗效分析[J].求医问药(下半月),2012,10(5):269.
[15]刘志刚,姜美英,曾敏帆,等.复方氟米松软膏和复方甘草酸苷片治疗皮炎湿疹临床疗效观察[J].江西医药,2009,44(9):908-910.
[16]杨俊.复方氟米松联合复方甘草酸苷治疗皮炎湿疹临床疗效观察[J].皮肤病与性病,2013,35(4):217+207.
[17]Diepgen TL,Andersen KE,Chosidow O,et al.Guidelines for diagnosis,prevention and treatment of hand eczema[J].J Dtsch Dermatol Ges,2015,13:e1-22.
[18]Jankowska-Konsur A,Reich A,Szepietowski JC.Systemic antihistamines--a common outside the guidelines therapeutic strategy in hand eczema management[J].J Eur Acad Dermatol Venereol,2016,30:67-71.