母牛分枝桿菌菌苗輔助治療復治肺結核的Meta分析_《中國循證醫學雜志》

作者：

范妙儀 ¹ ,  陳雪融 ¹ , 王可 ¹ , 毛輝 ¹ , 馮玉麟 ¹ , 唐曉燕 ¹ , 王莉 ²

1.四川大學華西醫院呼吸科 (成都 610041) 2.四川大學華西醫院中國循證醫學中心;

關鍵詞：

母牛分枝桿菌菌苗.微卡肺結核免疫治療 Meta分析

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目的　系統評價母牛分枝桿菌菌苗（微卡）聯合抗結核藥物治療復治肺結核的療效與安全性。
方法　檢索PubMed（1990~2006）、中文期刊全文數據庫（1997~2006）、萬方數據庫（1997~2006）、Cochrane臨床對照試驗數據庫(2006年第4期)、National Research Register(1996~2006)等，納入比較微卡輔助治療組與對照組的隨機對照臨床試驗，由兩名評價者獨立提取資料并進行方法學質量評價。試驗數據的統計分析采用Cochrane協作網提供的RevMan 4.2.2軟件。
結果　最終納入11個RCT。Meta分析結果顯示，微卡輔助治療組與對照組相比，痰菌陰轉情況[RR=1.36，95%CI（1.21，1.54）]，病灶吸收情況[RR=1.39，95%CI(1.13,1.72）]，病灶未吸收情況[RR=0.46，95%CI(0.36,0.60）]的差異均有統計學意義。未報道與微卡臨床應用相關的嚴重系統性不良反應。
結論　現有臨床證據表明，微卡聯合抗癆治療能有效改善復治肺結核患者的細胞免疫功能，增強化療效果，有助于痰菌轉陰，病灶好轉吸收。受本評價納入研究質量所限，尚需開展更多高質量的研究進一步分析。

引用本文： 范妙儀,陳雪融,王可,毛輝,馮玉麟,唐曉燕,王莉. 母牛分枝桿菌菌苗輔助治療復治肺結核的Meta分析. 中國循證醫學雜志, 2007, 07(6): 449-455. doi: 復制

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3.	Luo YA, Lu SH, Guo SL, et al. Immunotherapeutic effect of Mycobacterium vaccae on multi-drug resistant pulmonary tuberculosis. Chinese Journal of Tuberculosis and Respiratory Diseases, 2000, 23(2): 85-88.
4.	Song XD, Ren YW, Zhu H, et al. the efficacy of Mycobacterium vaccae on 36 cases of multi-drug resistant pulmonary tuberculosis. Clinical Medicine of China, 2002, 11(18): 1006.
5.	Zheng RT, Pan ZW. Clinical observation on therapeutic efficacy of Mycobacterium vaccae in treating the elderly patients with bacterium positive retreated pulmonary tuberculosis, Ningxia Med J, 2005, 27(1): 30-32.
6.	Zhou ZH, Shen HL. The clinical analysis of the adjuvant efficacy of Mycobacterium vaccae on recurrent smear-positive pulmonary tuberculosis. China Tropical Medicine, 2005, 5(5): 1009-1010,1015.
7.	Shangguan ZX, Zhou JY. The clinical observation on the effect of Mycobacterium vaccae plus chemotherapy on recurrent smear-positive pulmonary tuberculosis. Zhejiang medical Journal, 2005, 3(27): 236-238.
8.	Rao PA, Gan XF. The effect of chemotherapy plus Mycobacterium vaccae vaccine in treatment of 30 cases with recurrent pulmonary tuberculosis. Journal of Clinical Pulmonary Medicine, 2005, 5(10): 602.
9.	Yao HB, Sang HZ, Guo L, et al. The observation of the effect of the treatment of multi-drug resistant pulmonary tuberculosis with M Vaccae. The Journal of The Chinese Antituberculosis Association, 2005, 6(27): 389-392.
10.	Liu YH. The observation of the adjuvant efficacy of Mycobacterium vaccae on multi-drug resistant pulmonary tuberculosis. Chinese Journal of Primary Medicine and Pharmacy, 2006, 3(13): 492-493.
11.	Wang JY, Lin DW. The effect of Mycobacterium vaccae on multi-drug resistant pulmonary tuberculosis. Acta Medicinae Sinica, 2006, 3(19): 443-445.
12.	Zou LN, Shao YD,Wang RW, et al. The effect of Mycobacterium vaccae on 38 senior cases of recurrent smear-positive pulmonary tuberculosis. Journal of Clinical Pulmonary Medicine, 2006, 3(11): 377-378.
13.	Wu GD, Li LH. The effect of Mycobacterium vaccae plus Dipasic on 177 cases with recurrent pulmonary tuberculosis. The Journal of The Chinese Antituberculosis Association, 2006, supplement(28): 32.
14.	孫照平, 劉輝.母牛分枝桿菌菌苗用于結核病防治的研究現狀.中國防癆雜志,2006, 28(6): 413-415.
15.	World Health Organization. Treatment of tuberculosis: Guidelines for national programmes.WHO/CDS/ TB/ 2003.313. Geneva: WHO, 2003.
16.	衛生部疾病控制司.中國結核病防治規劃實施工作指南, 2002. 3.
17.	Jüni P, Altman DG, Egger M. Systematic reviews in health care: Assessing the quality of controlled clinical trials. BMJ, 2001, 323: 42–46.
18.	Alderson P, Green S, Higgins JPT. Cochrane Reviewers’ Handbook 4.2.2[updated March 2004]. In: The Cochrane Library, Issue 1, 2004.
19.	羅永艾, 盧水華, 郭述良, 等. 母牛分枝桿菌菌苗在難治性肺結核治療中的作用.中華結核和呼吸雜志, 2000, 23(2): 85-88.
20.	宋小冬, 任彥薇, 朱紅, 等. 微卡方案治療耐多藥肺結核36例療效觀察.中國綜合臨床, 2002, 11(18): 1006.
21.	鄭如添, 潘治文. 母牛分枝桿菌菌苗輔助治療老年復治菌陽肺結核臨床觀察.寧夏醫學雜志, 2005, 27(1): 30-32.
22.	周志紅,申紅連.母牛分枝桿菌菌苗輔助治療復治菌陽肺結核的臨床分析.中國熱帶醫學,2005,5(5): 1009-1010,1015.
23.	上官宗校,周建英.微卡聯合化療藥物治療復治涂陽肺結核的療效觀察.浙江醫學, 2005, 3(27): 236-238.
24.	饒平安,甘先鋒.化療藥物聯合微卡治療涂陽復治肺結核30例療效觀察.臨床肺科雜志,2005, 5(10): 602.
25.	姚恒波,尚好珍,郭磊,等.微卡輔助治療耐多藥肺結核的臨床研究.中國防癆雜志,2005, 6(27): 389-392.
26.	劉月花. 微卡菌苗輔助治療多種耐藥肺結核的療效觀察.中國基層醫藥, 2006, 3(13): 492-493.
27.	王繼業,林定文.母牛分枝桿菌菌苗在耐多藥肺結核治療中的作用.華夏醫學, 2006, 3(19): 443-445.
28.	鄒良能,邵以德,王人委,等.微卡治療老年復治涂陽肺結核38例療效觀察.臨床肺科雜志, 2006, 3(11): 377-378.
29.	吳高達,李力鴻. 微卡與力克菲蒺合用對177例復治肺結核臨床療效觀察.中國防癆雜志, 2006, 增刊(28): 32.
30.	Stanford JL, BahR GM, Rook GAM,et al.Immunotherapy with Mycobacterium vaccae as an adjunct to chemotherapy in the treatment of pulmonary tuberculosis.Tubercle,1990,71:87.

1. Sun ZP, Liu H. The present research of the effect of Mycobacterium vaccae on prevention and treatment of tuberculosis. The Journal of The Chinese Antituberculosis Association, 2006, 28(6): 413-415.
2. Department of Disease Control of Ministry of Health. Guideline on Enforcement of Chinese Tuberculosis Control Program, 2002. 3.
3. Luo YA, Lu SH, Guo SL, et al. Immunotherapeutic effect of Mycobacterium vaccae on multi-drug resistant pulmonary tuberculosis. Chinese Journal of Tuberculosis and Respiratory Diseases, 2000, 23(2): 85-88.
4. Song XD, Ren YW, Zhu H, et al. the efficacy of Mycobacterium vaccae on 36 cases of multi-drug resistant pulmonary tuberculosis. Clinical Medicine of China, 2002, 11(18): 1006.
5. Zheng RT, Pan ZW. Clinical observation on therapeutic efficacy of Mycobacterium vaccae in treating the elderly patients with bacterium positive retreated pulmonary tuberculosis, Ningxia Med J, 2005, 27(1): 30-32.
6. Zhou ZH, Shen HL. The clinical analysis of the adjuvant efficacy of Mycobacterium vaccae on recurrent smear-positive pulmonary tuberculosis. China Tropical Medicine, 2005, 5(5): 1009-1010,1015.
7. Shangguan ZX, Zhou JY. The clinical observation on the effect of Mycobacterium vaccae plus chemotherapy on recurrent smear-positive pulmonary tuberculosis. Zhejiang medical Journal, 2005, 3(27): 236-238.
8. Rao PA, Gan XF. The effect of chemotherapy plus Mycobacterium vaccae vaccine in treatment of 30 cases with recurrent pulmonary tuberculosis. Journal of Clinical Pulmonary Medicine, 2005, 5(10): 602.
9. Yao HB, Sang HZ, Guo L, et al. The observation of the effect of the treatment of multi-drug resistant pulmonary tuberculosis with M Vaccae. The Journal of The Chinese Antituberculosis Association, 2005, 6(27): 389-392.
10. Liu YH. The observation of the adjuvant efficacy of Mycobacterium vaccae on multi-drug resistant pulmonary tuberculosis. Chinese Journal of Primary Medicine and Pharmacy, 2006, 3(13): 492-493.
11. Wang JY, Lin DW. The effect of Mycobacterium vaccae on multi-drug resistant pulmonary tuberculosis. Acta Medicinae Sinica, 2006, 3(19): 443-445.
12. Zou LN, Shao YD,Wang RW, et al. The effect of Mycobacterium vaccae on 38 senior cases of recurrent smear-positive pulmonary tuberculosis. Journal of Clinical Pulmonary Medicine, 2006, 3(11): 377-378.
13. Wu GD, Li LH. The effect of Mycobacterium vaccae plus Dipasic on 177 cases with recurrent pulmonary tuberculosis. The Journal of The Chinese Antituberculosis Association, 2006, supplement(28): 32.
14. 孫照平, 劉輝.母牛分枝桿菌菌苗用于結核病防治的研究現狀.中國防癆雜志,2006, 28(6): 413-415.
15. World Health Organization. Treatment of tuberculosis: Guidelines for national programmes.WHO/CDS/ TB/ 2003.313. Geneva: WHO, 2003.
16. 衛生部疾病控制司.中國結核病防治規劃實施工作指南, 2002. 3.
17. Jüni P, Altman DG, Egger M. Systematic reviews in health care: Assessing the quality of controlled clinical trials. BMJ, 2001, 323: 42–46.
18. Alderson P, Green S, Higgins JPT. Cochrane Reviewers’ Handbook 4.2.2[updated March 2004]. In: The Cochrane Library, Issue 1, 2004.
19. 羅永艾, 盧水華, 郭述良, 等. 母牛分枝桿菌菌苗在難治性肺結核治療中的作用.中華結核和呼吸雜志, 2000, 23(2): 85-88.
20. 宋小冬, 任彥薇, 朱紅, 等. 微卡方案治療耐多藥肺結核36例療效觀察.中國綜合臨床, 2002, 11(18): 1006.
21. 鄭如添, 潘治文. 母牛分枝桿菌菌苗輔助治療老年復治菌陽肺結核臨床觀察.寧夏醫學雜志, 2005, 27(1): 30-32.
22. 周志紅,申紅連.母牛分枝桿菌菌苗輔助治療復治菌陽肺結核的臨床分析.中國熱帶醫學,2005,5(5): 1009-1010,1015.
23. 上官宗校,周建英.微卡聯合化療藥物治療復治涂陽肺結核的療效觀察.浙江醫學, 2005, 3(27): 236-238.
24. 饒平安,甘先鋒.化療藥物聯合微卡治療涂陽復治肺結核30例療效觀察.臨床肺科雜志,2005, 5(10): 602.
25. 姚恒波,尚好珍,郭磊,等.微卡輔助治療耐多藥肺結核的臨床研究.中國防癆雜志,2005, 6(27): 389-392.
26. 劉月花. 微卡菌苗輔助治療多種耐藥肺結核的療效觀察.中國基層醫藥, 2006, 3(13): 492-493.
27. 王繼業,林定文.母牛分枝桿菌菌苗在耐多藥肺結核治療中的作用.華夏醫學, 2006, 3(19): 443-445.
28. 鄒良能,邵以德,王人委,等.微卡治療老年復治涂陽肺結核38例療效觀察.臨床肺科雜志, 2006, 3(11): 377-378.
29. 吳高達,李力鴻. 微卡與力克菲蒺合用對177例復治肺結核臨床療效觀察.中國防癆雜志, 2006, 增刊(28): 32.
30. Stanford JL, BahR GM, Rook GAM,et al.Immunotherapy with Mycobacterium vaccae as an adjunct to chemotherapy in the treatment of pulmonary tuberculosis.Tubercle,1990,71:87.

《中國循證醫學雜志》

母牛分枝桿菌菌苗輔助治療復治肺結核的Meta分析

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《中國循證醫學雜志》

母牛分枝桿菌菌苗輔助治療復治肺結核的Meta分析

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

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