重组人血小板生成素治疗难治性特发性血小板减少性紫癜的循证评价

目的探讨重组人血小板生成素治疗难治性特发性血小板减少性紫癜的循证评价。方法采用循证医学和文献分析的评价方法,检索中国期刊全文数据库(CNKI)、美国全科医学文献数据库(MEDLINE)、中国生物文献数据库(CBM)、生物医药与药理学文献数据库(EMBASE)、循证医学数据库(COCHRANE),收集所有有关重组人血小板生成素治疗难治性特发性血小板减少性紫癜的研究文章。结果重组人血小板生成素治疗难治性特发性血小板减少性紫癜的文章共计9篇,其中以自身对照进行研究的文章6篇,以随机开放对照进行研究的文章3篇。经Jadad改良法评分,8篇文章<3分属于低质量文章,1篇文章>3分,为多中心且随机开放对照进行研究文章。以自身对照进行研究的6篇文章结果基本一致,重组人血小板生成素可以明显提高患者的血小板计数,且不良事件较少。以随机开放对照进行研究的3篇文章结果也基本一致,重组人血小板生成素联合达那唑用药治疗效果明显好于单独使用达那唑。达那唑单独用药也具有一定的临床疗效,可以大幅提高患者的血小板计数。结论目前现有的研究文章表明重组人血小板生成素治疗难治性特发性血小板减少性紫癜的临床疗效显著,不良事件较少,但也存在不足,缺乏大样本研究。

Evidence - based evaluation on refractory idiopathic thrombocytopenic purpura in the treatment with recombinant human thrombopoie- lin.

Objective To investigate the evidence -based evaluation on refractory idiopathic thrombocytopenic purpura in the treatment with recombinant human thrombopoietin. Methods The evaluation methods were evidence - based medicine and literature analysis retrieval. CNKI, MEDLINE, CBM, EMBASE, COCHRANCE database were retrievalled. All research articles about refractory idiopathic thrombocytopenic purpura in the treatment with relevant recombinant human thrombopoietin were collected. Results The number of research articles about refractory idiopathic thrombocytopenic purpura in the treatment with relevant recombinant human thrombopoietin was 9. The number of self controlled study was 6. The number of open randomized control study was 3. By modified Jadad scoring method, 8 articles were below 3 points, which were consid- ered low quality. Onlyl article was above 3 points, which was a number of center and random open control study article. The results of 6 self con- trolled study were basically consistent. The recombinant human thrombopoietin could significantly improve patient blood platelet count, which had fewer adverse events. The results of 3 open randomized control study were basically consistent. Recombinant human thrombopoietin combined with danazol treatment were obviously better than that of the single use of danazol. Danazol medication alone also had some clinical efficacy, which could greatly improve the patient~ platelet count. Conclusion Currently available research articles shows that the clinical curative effect of refrac- tory idiopathic thrembocytopenic purpura in the treatment with recombinant human thrombopoietin is remarkable, which has fewer adverse events. But that has some disadvantages too. There was no large sample study.