阿奇霉素与多西环素治疗生殖道沙眼衣原体感染疗效的Meta分析

目的 系统评价阿奇霉素与多西环素治疗生殖道沙眼衣原体感染的疗效。方法 计算机检索Cochrane图书馆、PubMed、EMBASE、CBMdisc、CNKI和万方数据库，搜索关于阿奇霉素与多西环素治疗生殖道沙眼衣原体感染的临床随机对照试验（RCT），以微生物学转阴作为判愈标准。治疗组采用阿奇霉素治疗，对照组采用多西环素治疗。检索时间为1980年1月1日至2017年10月。由两名研究者共同独立提取资料并评估纳入研究质量。采用 Stata?12.0软件对试验数据进行统计分析。结果 共纳入24篇文章，包括24个RCT、2 369例患者，阿奇霉素治疗组1 302例，多西环素治疗组1 067例。Meta分析结果显示，阿奇霉素与多西环素治疗生殖道沙眼衣原体感染的微生物学有效率差异有统计学意义。采用固定效应模型对数据合并分析后显示，多西环素有效率优于阿奇霉素，有效率差异为2.8%（95% CI，0.9% ~ 4.6%）。结论 阿奇霉素治疗生殖道沙眼衣原体感染后的微生物学有效率低于多西环素，但临床应用的确切疗效尚需更多的RCT证实。

Efficacy of azithromycin versus doxycycline in the treatment of genital Chlamydia trachomatis infection: a meta-analysis

Qin Bei, Liu Quanzhong Department of Dermatology and Venereology, Tianjin Medical University General Hospital, Tianjin 300052, China Corresponding author: Liu Quanzhong, Email: liuquanzhong@medmail.com.cn 【Abstract】 Objective To systematically evaluate the efficacy of azithromycin and doxycycline in the treatment of genital Chlamydia trachomatis infection. Methods Databases including Cochrane library, PubMed, EMBASE, CBMdisc, CNKI and Wanfang were searched from January 1, 1980 to October 2017 for randomized controlled trials （RCTs） comparing the efficacy of azithromycin versus doxycycline in the treatment of genital Chlamydia trachomatis infection. In these RCTs, negative microbiological findings were defined as cure. Patients in the treatment group were treated with azithromycin, and those in the control group were treated with doxycycline. Two researchers independently extracted data and evaluated the quality of these RCTs. Statistical analysis was done by using Stata 12.0 software. Results A total of 24 research reports were enrolled, including 24 RCTs and 2 369 patients. There were 1 302 patients in the azithromycin group and 1 067 in the doxycycline group. Meta-analysis showed that there was a significant difference in the microbiological response rate between the treatment group and the control group. A fixed-effect model was used to combine the response rate, and showed that the response rate to doxycycline was superior to that to azithromycin, with a risk difference of 2.8% （95% CI, 0.9% - 4.6%）. Conclusion The microbiological response rate to azithromycin is lower than that to doxycycline in the treatment of genital Chlamydia trachomatis infection, but more RCTs are required to confirm the clinical efficacy of doxycycline.