磷酸奥司他韦制剂治疗小儿手足口病疗效和安全性meta分析
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摘要
目的系统评价奥司他韦制剂治疗小儿手足口病临床疗效和安全性。方法利用计算机检索网络文献数据库,收集有关磷酸奥司他韦制剂治疗小儿手足口病疗效的随机对照实验研究,根据Cochrane推荐的策略评价文献质量,使用Rev-man5.3.5进行Meta分析。结果 Meta分析显示,奥司他韦制剂治疗小儿手足口病疗效较好[RR=1.14; 95%CI(1.10,1.19),P<0.001],与对照组比较,能显著减少患儿发热时间[MD=-1.01; 95%CI(-1.39,-0.63),P<0.00001]和出疹时间[MD=-1.22;95%CI(-2.02,-0.42),P=0.003],安全性较高[RR=1.46; 95%CI(0.80,2.66),P=0.22]。结论目前有限的证据证明磷酸奥司他韦制剂治疗小儿手足口病有较好的疗效和安全性。
Objective To evaluate the clinical efficacy and safety of oseltamivir in the treatment of hand,foot and mouth disease in children.Methods Randomized controlled trials on the efficacy of oseltamivir phosphate in the treatment of hand,foot and mouth disease in children were collected by using a computer-searched network literature database. The quality of the literature was evaluated according to Cochrane's recommended strategies. Revman 5.3.5 was used for meta analysis. Results Meta analysis showed that oseltamivir had a better efficacy [RR = 1.14; 95% CI( 1.10,1.19,95% CI( 1.10,1.19,P<0.001] in the treatment of hand,foot and mouth disease in children [RR = 1.14; 95% CI( 1.10,1.19,P<0.001],compared with the control group,it reduced fever time [MD =-1.01; 95% CI(-1.39,-0.39,-0.63),P<0.00001]and rash time [MD =-1.22; 95% CI(-2.02,-0.02,-0.42,-0.42),P = 0.003],higher safety [RR = 1.46 22]. Conclusion There was limited evidence that oseltamivir phosphate was effective and safe in the treatment of hand,foot and mouth disease in children.
Objective To evaluate the clinical efficacy and safety of oseltamivir in the treatment of hand,foot and mouth disease in children.Methods Randomized controlled trials on the efficacy of oseltamivir phosphate in the treatment of hand,foot and mouth disease in children were collected by using a computer-searched network literature database. The quality of the literature was evaluated according to Cochrane's recommended strategies. Revman 5.3.5 was used for meta analysis. Results Meta analysis showed that oseltamivir had a better efficacy [RR = 1.14; 95% CI( 1.10,1.19,95% CI( 1.10,1.19,P<0.001] in the treatment of hand,foot and mouth disease in children [RR = 1.14; 95% CI( 1.10,1.19,P<0.001],compared with the control group,it reduced fever time [MD =-1.01; 95% CI(-1.39,-0.39,-0.63),P<0.00001]and rash time [MD =-1.22; 95% CI(-2.02,-0.02,-0.42,-0.42),P = 0.003],higher safety [RR = 1.46 22]. Conclusion There was limited evidence that oseltamivir phosphate was effective and safe in the treatment of hand,foot and mouth disease in children.
引文
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[15]陈敏,吴爱芳.个性化综合护理辅助磷酸奥司他韦治疗小儿手足口病120例[J].中国药业,2015,24(17):128-129.
[16]王凯锋.奥司他韦联合喜炎平治疗手足口病的疗效[J].世界最新医学信息文摘,2015,15(93):110-121.
[17]赖河生.奥司他韦口服联合阿昔洛韦乳膏外用治疗手足口病的临床效果分析[J].心血管病防治知识(学术版),2017(9):130-132.
[18]杨国龙.磷酸奥司他韦颗粒治疗手足口病的研究进展[J].中外医学研究,2018,16(18):186-188.
[19]程能能,陈斌艳,王永铭.新型口服抗流感药---奥司他韦[J].中国临床药学杂志,2002(1):55-59.
[20]SU P Y,LIU Y T,CHANG H Y,et al.Cell surface sialylation affects binding of enterovirus 71 to rhabdomyosarcoma and neuroblastoma cells[J].Bmc Microbiology,2012,12(1):162.
[21]王文文,汤光明,田健美,等.EV71感染所致手足口病的流行病学及其普通型和脑炎型的临床特征分析[J].右江民族医学院学报,2018,40(2):145-148.
[2]罗秀状,李强,陈霞静,等.重症和危重症手足口病并脑炎136例临床观察[J].右江民族医学院学报,2010,32(6):905-906.
[3]王新敏,薛继军,陈富新.磷酸奥司他韦的临床应用进展[J].中国处方药,2014,12(3):125-127.
[4]HIGGINS J P,GREEN S.Cochrane handbook for systematic reviews of interventions version 5.1.0(2011-03)[M/OL.The CochraneCollaboration,2011.http://www.cochrane.org/handbook.
[5]曾胜峰.奥司他韦口服联合阿昔洛韦乳膏外用治疗手足口病的临床效果观分析[J].中外医疗,2016,35(29):127-129.
[6]吴立明,王丰,付省威,等.奥司他韦联合阿昔洛韦乳膏对手足口病的疗效及CRP水平的影响[J].西北药学杂志,2018,33(2):244-246.
[7]胡建英.磷酸奥司他韦颗粒的临床应用观察[J].临床合理用药杂志,2015,8(13):23-25.
[8]徐卫.磷酸奥司他韦颗粒在辅助治疗小儿手足口病的临床效果观察[J].临床合理用药杂志,2016,9(26):63-64.
[9]周招鹏,胡梦泽.磷酸奥司他韦颗粒联合单磷酸阿糖腺苷治疗小儿手足口病的疗效观察[J].现代药物与临床,2016,31(9):1427-1429.
[10]蔡志军,刘小生,刘跃梅.磷酸奥司他韦颗粒辅治小儿手足口病临床疗效观察[J].临床合理用药杂志,2013,6(13):89-90.
[11]ADHISIVAM B,VENKATESH C.Oseltamivir for hand,foot and mouth disease[J].Indian Pediatr,2015 Aug,52(8):716.
[12]司马贯忠,陈丙文,杨昕.磷酸奥司他韦颗粒辅助治疗小儿手足口病的效果评价[J].中国医药科学,2018,8(4):51-57.
[13]唐群兰,罗宗初,张电,等.磷酸奥司他韦颗粒联合西咪替丁治疗手足口病120例疗效观察[J].中国现代药物应用,2015,9(10):103-104.
[14]郭辉,贾贻红.治疗手足口病的临床药物综述[J].中国医药指南,2009,7(22):66-67.
[15]陈敏,吴爱芳.个性化综合护理辅助磷酸奥司他韦治疗小儿手足口病120例[J].中国药业,2015,24(17):128-129.
[16]王凯锋.奥司他韦联合喜炎平治疗手足口病的疗效[J].世界最新医学信息文摘,2015,15(93):110-121.
[17]赖河生.奥司他韦口服联合阿昔洛韦乳膏外用治疗手足口病的临床效果分析[J].心血管病防治知识(学术版),2017(9):130-132.
[18]杨国龙.磷酸奥司他韦颗粒治疗手足口病的研究进展[J].中外医学研究,2018,16(18):186-188.
[19]程能能,陈斌艳,王永铭.新型口服抗流感药---奥司他韦[J].中国临床药学杂志,2002(1):55-59.
[20]SU P Y,LIU Y T,CHANG H Y,et al.Cell surface sialylation affects binding of enterovirus 71 to rhabdomyosarcoma and neuroblastoma cells[J].Bmc Microbiology,2012,12(1):162.
[21]王文文,汤光明,田健美,等.EV71感染所致手足口病的流行病学及其普通型和脑炎型的临床特征分析[J].右江民族医学院学报,2018,40(2):145-148.