尼美舒利治疗汉族人群类风湿关节炎的疗效和不良反应的Meta分析

【摘　要】　

目的　运用Meta分析方法综合评价尼美舒利治疗汉族人群类风湿关节炎的疗效和不良反应。

方法　通过计算机检索CNKI、万方、PubMed数据库, 结合文献追溯和采用公共搜索引擎(www. baidu. com; www. google. com)网上查询，收集所有关于尼美舒利治疗类风湿关节炎的疗效和不良反应的研究。以尼美舒利组与对照组疗效和不良反应的RR值为效应指标，各资料间进行一致性检验，以确定采用固定或随机效应模型进行合并分析。

结果　共入选相关文献9篇，试验地点均在中国大陆。在有关疗效的研究中尼美舒利组436例，对照组422例;有关不良反应的研究中尼美舒利组462例，对照组476例。文献发表的“漏斗图”分布不对称，提示可能有阴性结果试验未发表，有潜在发表偏倚。META分析显示尼美舒利治疗类风湿关节炎的疗效与其他药物相比差异无统计学意义[ RR = 1. 07, 95%CI(0. 99, 1. 15) , P = 0. 09 ] ，不良反应差异亦无统计学意义[ RR = 0. 92, 95%CI(0. 70, 1. 22) ，P = 0. 56 ]。

结论　尼美舒利治类风湿关节炎的疗效和不良反应可能与其他药物无明显差异。但因本研究纳入的试验样本量较小且方法学质量低下，故仍有必要进行大样本、多中心、随机、双盲对照试验，以进一步了解尼美舒利治疗类风湿关节炎的疗效及不良反应。

【关键词】　尼美舒利；疗效；不良反应；Meta分析

Meta-analysis on the effectiveness and side reaction of Nimesulide for the treatment of rheumatoid arthritis among Han Nationality

【Abstract】　

Objective　To investigate the effectiveness and side reaction via Meta-analysis, when rheumatoid arthritis was treated with Nimesulide Han Chinese. Methods　Related studies were collected by retrieving literatures in PubMed, CNKI and Wangfang Databases. In addtion, searching related literatures on the Internet (www. baidu. com and www. google. com) and tracing back literatures were also carried out. The effectiveness and side reaction was evaluated by Risk Ratio, and fixed or random effect models were selected to analyze the data according to the heterogeneity tested by chi square test. Publication bias was assessed by funnel p lot then. All statistical analyses were conducted with Review Manager 4. 2.

Results　9 studies, all in ChineseMainland, are selected. Meta-analysis showed that the statistical differences between treatment group for Nimesulide and control group were not significant in effectiveness[RR = 1. 07, 95%CI(0. 99, 1. 15) , P = 0. 09 ] and side reaction[RR = 0. 92, 95%CI(0. 70, 1. 22) , P = 0. 56 ].

Conclusion 　The effectiveness and side reaction of Nimesulide for rheumatoid arthritis, compared with other medications, do not show significant differences. However, not all studies are collected and the collected ones are of low methodological quality, hence high quality and double-blind RCTs with large samples and multi-centers are needed to study about its effectiveness and side reaction.

【Key words】　Nimesulide; Effectiveness; Side reaction; Meta-analysis

临床合理用药 2009年 4月第 2卷第 7期　Chin J of Clinical RationalDrug Use, April 2009,Vol 2 No 7