復治涂陽肺結核繼續期治療方案的循證評價_《中國循證醫學雜志》

作者：

楊曉妍 , 毛秀 , 孫鑫 , 段蔭喬 ,  李幼平

四川大學華西醫院中國循證醫學中心（成都 610041）;

關鍵詞：

復治涂陽肺結核固定劑量聯用（FDC）利福平異煙肼乙胺丁醇

視頻：

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摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的　循證評價復治涂陽肺結核繼續期治療方案，為WHO基本藥物目錄（WHO EML）調整及國家指南更新提供依據。
方法　計算機檢索官方網站和CBMdisc（1978～2006），Cochrane 圖書館（2006年第4期），DARE（1994～2006），MEDLINE（1950～2006），EMBASE（1974~2006），BIOSIS Previews（1997~2006）等數據庫，同時手檢相關雜志和參考文獻。按照納入、排除標準嚴格選擇文獻。對納入文獻分類分級，循證分析。
結果　共納入28篇RCT，4篇CCT，11篇敘述性研究和5篇WHO/ 國家指南。WHO及高結核負擔國家結核防治指南中Ⅱ類結核治療繼續期均使用利福平、異煙肼和乙胺丁醇，但療程、劑量有差異。此外，此3藥也較多用于其它類型結核。
結論　建議將利福平（R）、異煙肼（H）和乙胺丁醇（E）固定劑量聯用（FDC-RHE）納入WHO EML2007用于復治涂陽肺結核的治療；HRE劑量比例建議為1∶1∶2，劑量為H 150 mg， R 150 mg，E 300 mg。最佳劑量尚須根據更多高質量臨床研究以指導調整。有必要開展對WHO及高結核負擔國家結核防治指南有效性、安全性、經濟性和適用性的臨床研究，并對其進行系統評價，以考察結核用藥方案效果，指導指南更新和資源合理配置，提高治療績效。有必要加強替代/備選藥物研究，開發有效、安全、經濟、適用的抗結核藥物及藥物組合用于耐藥結核的防治。

引用本文： 楊曉妍,毛秀,孫鑫,段蔭喬,李幼平. 復治涂陽肺結核繼續期治療方案的循證評價. 中國循證醫學雜志, 2007, 07(3): 211-221. doi: 復制

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4. Li BY. Observation on Curative Effect of Positive Bacteria Pulmonary Tuberculosis Treated by Chemotherapy and BCG- PSN. Journal of Preventive Medicine Information, 2001, 17(6): 427–428.
5. Yu D, Wang J, Hu X. Clinical research of pasinizid on retreated sputum positive pulmonary tuberculosis in senilities. Chinese Journal of Tuberculosis and Respiratory Diseases, 2001, 24(10): 608–610.
6. Cheng HL, Hu JG, Hu XW. The Comparison of the Clinical Effects of Using Lifuxin and Lifuping in the Treatment of Retreated Tuberculosis. Journal of Clinical Pulmonary Medicine, 2003, 8(3): 223–225.
7. Zeng L,Wang GB, Gao SY, et al. Clinical research of intravenous drip of capastat sulfate treating for the patients with tuberculosis. Henan Medical Research, 2002, 11(3): 230–232.
8. Chen YZ. Clinical Observation on the Clinical Efficacy and Safety of Retreated and Smear Positive Patient with Pulmonary Tuberculosis Treated by Levofloxcin. Journal of Jiangsu University (Medicine Edition), 2004, 14(2): 120–122.
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《中國循證醫學雜志》

復治涂陽肺結核繼續期治療方案的循證評價

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