巴氯芬治疗顽固性呃逆的有效性和安全性的系统评价

Systematic Review on Efficacy and Safety of Baclofen in the Treatment of Intractable Hiccup

关键词:  巴氯芬  顽固性呃逆  有效性  安全性  系统评价

Key words:  baclofen  intractable hiccup  efficacy  safety  systematic review

摘要:

目的 系统评价巴氯芬治疗顽固性呃逆的有效性和安全性。方法 计算机检索中国期刊全文数据库（CNKI）、万方数据库、维普数据库（VIP）、PubMed、Embase和Cochrane Library数据库，收集巴氯芬用于治疗顽固性呃逆的随机对照研究。由2位研究者按照纳入排除标准独立筛选文献、提取资料并评价纳入试验的偏倚风险，用RevMan 5.3软件进行meta分析。结果 共纳入16项随机对照试验，共889例患者。Meta分析结果显示，与对照组相比，巴氯芬能有效治疗顽固性呃逆[RR=1.43，95%CI（1.27，1.59），P<0.000 01]，起效快[SMD=-3.67，95%CI（-5.98，-1.37），P=0.002]，疗程短[WMD=-2.88，95%CI（-4.37，-1.39），P=0.000 1]，同时不良反应的发生两组间无统计学差异[RR=0.64，95%CI（0.43，0.96），P=0.03]。结论 基于现有证据，巴氯芬治疗顽固性呃逆具有良好的有效性和安全性。

Abstract:

OBJECTIVE To systematically review the efficacy and safety of baclofen in the treatment of intractable hiccup. METHODS CNKI, Wangfang database, VIP, Pubmed, Embase and the Cochrane library were searched to collect randomized control trials(RCTs) regarding the treatment of intractable hiccup by baclofen. Two reviewers independently screened literatures, extracted data and assessed the risk bias of included studies according to the inclusion and exclusion criteria. Then, meta-anaysis was performed using Revman 5.3 software. RESULTS Sixteen RCTs involving 889 patients were included. The results of meta-analysis showed that, compared with control group, baclofen was more effective for the treatment of intractable hiccup[RR=1.43, 95%CI(1.27, 1.59), P<0.000 01], had rapider onset[SMD=-3.67, 95%CI(-5.98, -1.37), P=0.002], and shorter course[WMD=-2.88, 95%CI(-4.37, -1.39), P=0.000 1]. There was no statistically significant difference in the incidence of adverse reactions[RR=0.64, 95%CI(0.43, 0.96), P=0.03] between two groups. CONCLUSION Baclofen is effective and safe in the treatment of intractable hiccup according to currently available evidence.