Objective To assess the efficacy and safety of mesalazine versus sulfasalazine in the treatment of ulcerative colitis.Methods The literatures were searched from PubMed (1966 to January 2010), the Cochrane Library (1966 to January 2010), EMbase (1974 to January 2010), CNKI (1994 to January 2010), VIP (1989 to January 2010), and CBM (1978 to January 2010). The data were extracted, the quality of studies was evaluated according to The Cochrane Handbook, and meta-analyses were performed using RevMan 5.0 software. Results Sixteen RCTs involving 1 333 patients were included in this study. The results of meta-analyses showed that the total effective rate of the mesalazine group was significantly higher than that of the sulfasalazine group (RR=1.10, 95%CI 1.04 to 1.17, Plt;0.05), and significant differences were noted in the total remission rate (RR=1.82, 95%CI 1.14 to 2.91, Plt;0.05), while there was no significant difference in the relapse rate between the two groups (RR=0.86, 95%CI 0.57 to 1.29, Pgt;0.05). Twelve RCTs reported adverse effects and meta-analyses showed that the incidence of adverse effects was significantly lower in the mesalazine group than in the sulfasalazine group (RR=0.56, 95%CI 0.42 to 0.73, Plt;0.05). Conclusion Analyses show that mesalazine is much more effective and safe in the management of ulcerative colitis than sulfasalazine. However, there is a moderate risk of bias due to methodological quality problems in all 16 included RCTs, so more strictly-designed multi-centered randomized controlled trials with high quality in large-scale are needed to confirm this result.
【摘要】 目的 采用循證醫學的方法評價硫唑嘌呤（aiathioprine，AZA）治療潰瘍性結腸炎（ulcerative colitis，UC）的有效性和安全性。 方法 計算機檢索PubMed、Cochrane library、Embase、CNKI、維普和CBM數據庫收集國內外關于AZA診療UC的隨機對照試驗（ramdomized controllel trial，RCT）。按Cochrane系統評價的方法評價納入研究質量，并進行Meta分析。 結果 共納入5個RCT，共262例UC患者。Meta分析結果顯示，AZA治療UC在緩解率方面與安慰劑比較，差異無統計學意義[P=1.19，95%CI（0.94，1.49），P=0.14]；在復發率方面，兩者比較差異有統計學意義[P=0.72，95%CI（0.54，0.95），P=0.02]；全部不良反應方面和嚴重不良反應方面，兩者比較差異無統計學意義，Meta分析結果分別為[P=2.52，95%CI（0.82，7.74），P=0.11]和[P=4.03，95%CI（0.88，18.53），P=0.07]。 結論 系統評價結果為AZA在療效方面優于安慰劑，在不良反應發生率方面差異無統計學意義。但由于納入的5個研究中沒有高質量的RCT，且有1個可能產生高度偏倚，使得這一結論受到影響，有必要開展更多設計嚴謹，大樣本、多中心的RCT。【Abstract】 Objective To assess the efficacy and safety of azathio-prine in the treatment of ulcerative colitis through an evidence-based method. Methods We searched the literature from databases like PubMed, Cochrane library, CNKI, VIP, and CBM, and evaluated the quality of studies according to Cochrane systematic review. Finally, Meta-analysis was performed. Results Five randomized controlled trials (RCT) were included in this study with a total of 262 patients. Meta-analysis showed that there was no significant difference in the rate of remission between azathio-prine and placebo in treating ulcerative colitis [P=1.19, 95%CI (0.94, 1.49),P=0.14]. There was significant difference in the relapse rate between the two treating methods [P=0.72, 95%CI (0.54, 0.95),P=0.02]. In addition, there was no statistical difference in all adverse effects [P=2.52, 95%CI (0.82, 7.74),P=0.11] and serious adverse effects [P=4.03, 95%CI (0.88, 18.53),P=0.07] between the two treating methods. Conclusion In the treatment of ulcerative colitis, azathio-prine has a significant advantage in efficacy than placebo, but there is no significant difference in the rate of adverse events between the two groups. However, none of the 5 RCT included in this review has a high quality and one of them even probably has a high bias, which has a big influence on our conclusion. Consequently, multi-center large-scale randomized controlled trials of higher quality are needed to make confirmation.
【摘要】 目的 了解2007年-2008年成都地區17家醫院抗腫瘤藥物的使用情況。 方法 以銷售金額、用藥頻度（DDDs）對2007年、2008年成都地區17家醫院抗腫瘤藥物消耗數據進行分類統計、綜合分析、對比。 結果 2008年成都地區17家醫院抗腫瘤藥物用藥金額增長幅度較大，各亞類抗腫瘤藥物中其它類抗腫瘤藥物類、植物來源的抗腫瘤藥、抗代謝藥金額排序依次占前3位。銷售金額前100位藥物中，腫瘤藥物占據8位，大多數是其它類抗腫瘤藥物，且其用藥頻度也靠前。 結論 抗腫瘤藥物用藥金額和用藥量都將快速增長，其中其它類抗腫瘤藥物和植物來源的抗腫瘤藥的發展尤被看好。【Abstract】 Objective To evaluate the situation of antineoplastics used in Chengdu area from 2007 to 2008. Methods The consumption data of antineoplastics used in 17 hospitals of Chengdu area in 2007 and 2008 were classified, and the consumption sum and defined daily doses (DDDs) were analyzed. Results The total consumption sum of antineoplastics in 2008 increased sharply. Other antineoplastics, herbal-sourced antineoplastics and antimetabolism drugs ranked in the first three places. Among the top drugs in terms of consumption sum, antineoplastics took 8 places. Conclusion The consumption sum and DDDs of antineoplastics, especially other antineoplastics and herbal-sourced antineoplastics, will increase rapidly.
