青蒿素类药物预防日本血吸虫感染效果及安全性的系统评价

目的 分析青蒿素类药物预防日本血吸虫病的效果和可能的不良反应或毒副作用。方法 纳入以高危人群为研究对象的随机对照试验,对纳入研究的质量进行评价,并进行Meta分析。结果 10个预防日本血吸虫病的随机对照试验符合纳入标准,均为高质量研究。其中4个为多中心研究,6个为单中心研究。纳入人数范围从318人至5098人,共计12829人。汇总OR 0．11(95％CI 0．06～0．21)表明口服青蒿素类药物的干预组的血吸虫感染率远低于对照组,差异有统计学意义。未发现符合本系统评价规定的毒副作用。结论 青蒿素类药物可有效预防日本血吸虫病;尚需更多高质量研究以比较各种服药方案之间的优劣。

Systematic review of benefits and harms of artemisinin-type compounds for preventing schistosomiasis

Objective To assess the benefits and harms of artemisinin-type compounds for preventing schistosomiasis. Method The quality of included randomised controlled trials with the people at risk of contacting schistosomiasis were evaluated and Meta-analysis was conducted. Results We found ten randamised controlled trials relating to our question. Of them, four trials were multi-centre studies, others were single centre studies. Numbers of participants in the trials ranged from 318 to 5 098, total 12,829. The total OR of 0.11 (95%CI 0.06 to 0.21) indicated that those who were administrated artemisinin-type compounds were significantly less infected with Schistosoma japonica than those who were administrated placebo. Conclusion Artemisinin-type compounds are effective drug for preventing Schistosomiasis japonica infection. Fifteen days interval schemes of artesunate and artemether be considered preferable to seven days interval scheme and were associated with very few side effects. More high quality controlled trials are required for assessing which scheme is the better. These studies should be large.