摘要
目的系统评价塞来昔布治疗类风湿性关节炎和骨关节炎的有效性和安全性。方法计算机检索EMbase、PubMed、e Cochrane Library、CBM、CJFD和CSJD,搜集有关塞来昔布治疗类风湿性关节炎或骨关节炎的随机对照试验(RCT)。由两位研究者按照纳入与排除标准筛选文献、提取资料和评价质量后,采用RevMan 5.0软件进行Meta分析。结果共纳入4个RCT,共2 931例患者。Meta分析结果显示:①不同剂量的塞来昔布和500 mg bid的萘普生治疗类风湿性关节炎或骨关节炎的效果差异有统计学意义;②塞来昔布和安慰剂组的胃肠道反应差异无统计学意义[RR=1.29,95%CI(0.93,1.79)];③塞来昔布和萘普生的胃肠道反应差异有统计学意义[RR=0.78,95%CI(0.64,0.95)];④塞来昔布和萘普生治疗类风湿性关节炎或骨关节炎的胃肠道溃疡程度差异有统计学意义[RR=1.29,95%CI(0.93,1.79)]。ITT分析结果表明:塞来昔布和萘普生治疗类风湿性关节炎或骨关节炎的胃肠道副反应程度差异有统计学意义[RR=0.84,95%CI(0.77,0.92)]。结论不同剂量塞来昔布治疗类风湿性关节炎或骨关节炎和500 mg bid的萘普生相比,其疗效相差各异,但塞来昔布的胃肠道反应与安慰剂相当,低于萘普生组。但上述结果尚需高质量的随机对照试验进一步验证。
Objective To evaluate the efficacy and safety of Celecoxib and Naproxen for treating osteoarthritis or rheumatoid arthritis.Methods Such databases as EMbase,PubMed,The Cochrane Library,Chinese Biomedical Literature Database（CBM）,China Journal Full-text Database（CJFD）,and Chinese Scientific Journal Full-text Database（CSJD） were searched to collect the randomized controlled trials（RCTs） of Celecoxib and Naproxen for treating osteoarthritis or rheumatoid arthritis.Two reviewers independently assessed the quality of the included studies and extracted the data.The Review Manager（version 5.0） software was used to analyze the data.Results Four RCTs involving 2 931 patients were included.The results of meta-analyses were as follows： a） There were significant differences in the dose of Celecoxib and Naproxen for treating rheumatoid arthritis or osteoarthritis;b） There was no significant difference in gastrointestinal reaction between the Celecoxib group and the placebo group（RR=1.29,95%CI 0.93 to 1.79）;c） The were significant differences in gastrointestinal reaction between the Celecoxib group and the Naproxen group（RR=0.78,95%CI 0.64 to 0.95）;d） There were significant differences in inducing the severity of Stomach and Duodenum Endoscopy Score between the Celecoxib group and the Naproxen group when treating rheumatoid arthritis or osteoarthritis（RR=1.29,95%CI 0.93 to 1.79）.As the Intention-To-Treat（ITT） analysis showed,there were significant differences in inducing the severity of gastrointestinal reaction between the Celecoxib group and the Naproxen group when treating rheumatoid arthritis or osteoarthritis（RR=0.84,95%CI 0.77 to 0.92）.Conclusion Compared with Naproxen,there are significant differences in efficacy for treating rheumatoid arthritis and osteoarthritis with Celecoxib in different doses.The Celecoxib has no significant difference in gastrointestinal reaction compared with the placebo group.The Celecoxib group has fewer gastrointestinal side-effects as compared with the Naproxen group,so it can be used to treat rheumatoid arthritis and osteoarthritis in clinic.The results still need to be confirmed by high-quality RCTs.
出处
《中国循证医学杂志》
CSCD
2011年第5期560-564,共5页
Chinese Journal of Evidence-based Medicine
