非甾体抗炎药治疗骨关节炎和类风湿性关节炎的疗效和不良反应的Meta分析

目的 根据现有临床资料评估中国骨关节炎和类风湿性关节炎患者服用非甾体抗炎药(NSAID)的临床疗效和不良反应发生率。方法 利用Meta分析的方法综合国内1990～2001年关于：NSAID疗效和不良反应的随机对照研究文献19篇。统计有效率累计人选病例共1732例，统计不良反应累计入选病例2925例。结果 不同类型NSAID的疗效和不良反应发生率存在较大的异质性，有效率(95％CI)萘丁美酮66．7％(61．9％～71．4％)、美洛昔康68．4％(59．2％～77．6％)、萘普生64，5％(59．8％～69．1％)、尼美舒利79．8％(75．7％～84．0％)、布洛芬77．2％(70．7％～83．8％)、双氯芬酸77．1％(69．2％～85．0％)、恶丙嗪65．8％(59．5％～72．0％)。不良反应发生率(95CI)萘丁美酮16．3％(12．5％～20．0％)、美洛昔康10．2％(4．2％～16．2％)、萘普生29．2％(24．8％～33．6％)、尼美舒利20．2％(16．0％～24．3％)、布洛芬16．7％(14．7％～18．8％)、双氯芬酸19．3％(11．9％～26．7％)、恶丙嗪12．7％(8．9％～16．7％)。结论 中国骨关节炎和类风湿性关节炎患者服用NSAID的有效率和不良反应发生率因药品而异。连续用药2～8周，萘丁美酮、美洛昔康等常用NSAID的有效率在59．2％～85．0％之间，不良反应发生率在4．2％～33．6％之间。

Meta-analysis on the effect and adverse reaction on patients with osteoarthritis and rheumatoid arthritis treated with non-steroidal anti-inflammatory drugs

ObjectiveTo observe the rate of efficacy and adverse drug reaction of non-steroidal anti-inflammatory drugs (NSAIDs) in the population with osteoarthritis and rheumatoid arthritis, based on availabl e clinical data. MethodsUsing Meta analysis to evaluate the data of effec t and safety profile of NSAIDs from 19 articles on randomized clinical trials pu blished from 1990 to 2001 in Chinese journals. The total number of patients enro lled for evaluation on rates of effectiveness and adverse drug reaction were 1 732 and 2 925 ,respectively. ResultsData on the effect and safety were comparatively hete rogeneous among different kinds of NSAIDs. The effective rates (95%CI) were as follows: nabunetone, 66.7 %( 61.9%- 71.4 %); meloxicam, 68.4 %( 59.2%- 77.6 %);naproxen, 64.5 %( 59.8%- 69.1 %); nimesulide, 7 9.8 %( 75.7%- 84.0 %); ibuprofen, 77.2 %( 70.7%- 83.8 %); diclof enac, 77.1 %( 69.2%- 85.0 %); oxaprozin, 65.8 %( 59.5%- 72.0 % ). Rates of adverse drug reaction (95%CI) were as follows: nabunetone, 16. 3 %( 12.5%- 20.0 %);meloxicam, 10.2 %( 4.2 %- 16.2 %);naproxen, 29.2 %( 24.8%- 33.6 %);nimesulide, 20.2 %( 16.0%- 24.3 %);ibuprofen, 16.7 %( 14.7%- 18.8 %);diclofnec, 19 .3 %( 11.9%- 26.7 %);oxaprozin, 12.7 %( 8.9%- 16.7 %)respectivel y. ConclusionThe rates of effect and adverse reaction on patients having oeteoarthritis and rheumatoid arthritis with NSAIDs treatment would lar gely depend on the drugs being used. Within 2- 8 weeks of treatment, the eff ective rate and rate of adverse drug reaction with commonly used NSAIDs as nabum eton, meloxicam, etc., were 59.2%- 85.0 % and 4.2%- 33.6 %, respe ctively.