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目的 :评价国内莫西沙星与左氧氟沙星治疗耐多药结核病的疗效及安全性。方法 :计算机检索中国生物医学文献数据库、中国期刊全文数据库、万方数据库及维普中文科技期刊全文数据库,收集2000年1月~2014年6月莫西沙星与左氧氟沙星治疗耐多药结核病的随机对照试验(RCT)文献,对纳入研究进行方法学质量评价,并采用Rev Man 5.3.0软件进行Meta分析。结果:共纳入36个RCT。Meta分析结果显示,莫西沙星组与左氧氟沙星组相比,莫西沙星可提高服药后3个月痰菌转阴率(OR=2.25,95%CI:1.87~2.70)、疗程结束时痰菌转阴率(OR=3.70,95%CI:2.97~4.62)、病灶吸收率(OR=2.45,95%CI:1.90~3.17)、空洞闭合率(OR=1.82,95%CI:1.45~2.29)以及临床总有效率(OR=5.08,95%CI:3.58~7.22)。两组不良反应发生率差异无统计学意义(P=0.14)。结论:目前国内证据表明,莫西沙星可有效治疗耐多药结核病,其疗效优于左氧氟沙星,不良反应发生率与其相当。
Objective: To evaluate the efficacy and safety of domestic moxifloxacin and levofloxacin in the treatment of multidrug-resistant tuberculosis. Methods: A randomized controlled trial of moxifloxacin and levofloxacin in the treatment of multidrug-resistant tuberculosis (MDR-TB) was collected from January 2000 to June 2014 in the Chinese biomedical literature database, Chinese periodical full-text database, Wanfang database and VIP Chinese scientific journal. (RCT) literature to evaluate the methodological quality of included studies and Meta-analysis using Rev Man 5.3.0 software. Results: A total of 36 RCTs were included. Meta-analysis showed that compared with levofloxacin group, moxifloxacin increased the rate of sputum negative conversion (OR = 2.25, 95% CI: 1.87-2.70) after 3 months of treatment. After the course of treatment, (OR = 2.45, 95% CI: 1.90-3.17), void closure rate (OR = 1.82, 95% CI: 1.45-2.29) Clinical total effective rate (OR = 5.08, 95% CI: 3.58 ~ 7.22). There was no significant difference in the incidence of adverse reactions between the two groups (P = 0.14). Conclusion: At present, domestic evidence shows that moxifloxacin can effectively treat multidrug-resistant tuberculosis and its efficacy is superior to that of levofloxacin, with a similar incidence of adverse reactions.