非甾体抗炎药预防结直肠息肉的系统评价

目的　评价非甾体抗炎药 (NSAIDs )是否能降低结直肠息肉发生的危险性 ,以及长期使用这些药物的安全性。方法　应用国际Cochrane协作网的系统评价方法对全世界关于NSAIDs与安慰剂或空白对照比较的随机临床对照试验进行系统评价。结果　共有 8篇随机临床对照试验被纳入评价。分析结果显示阿司匹林可以预防结直肠腺瘤的发生 (P =0 0 0 3 ) ,但没有证据支持长期使用苏林酸和塞来昔布可以减少结直肠腺瘤发生的危险性 (P >0 0 5) ,也无证据证明结直肠腺瘤预防与NSAIDs的剂量有关。无论使用阿司匹林还是安慰剂 ,结直肠癌发生的机会相似 (P =0 8)。未发现NSAIDs和安慰剂组间不良反应有差异。结论　在结直肠腺瘤或结直肠癌术后的患者 ,长期使用阿司匹林可减少腺瘤的发生 ;目前尚无常规剂量阿司匹林可减少结直肠癌发生的证据 ,也无长期使用苏林酸和塞来昔布可减少结直肠腺瘤发生危险性的证据

Non-steroidal anti-inflammatory agents for chemoprevention of colorectal polyps: a meta-analysis

ObjectiveTo assess whether or not non-steroidal anti-inflammatory agents (NSAIDs) might prevent colorectal polyps MethodsA systematic review of all relevant randomized controlled trials was performed We searched all randomized controlled trials of chemoprevention of colorectal polyps Abstracts was included Results8 trials were assessed in the final systematic analysis We found a sufficient evidence to support that aspirin might prevent the development of colorectal adenomas in comparing with placebo group in two trails of high quality and large sample (P=0 003) However, there is no evidence to support that sulindac and celecoxib might cure or prevent colorectal adenomas or familial adenomatous polyposis (P>0 05) and also no evidence to support that dosage of NSAIDs is related with the result of prevention of colorectal adenomas It was shown that regular aspirin use for 30-60 months cannot reduce the risk of colorectal cancer (P=0 8) No significant differnce in the number of adverse events was found between patients taking NSAIDs and those given placebo (P=0 9) ConclusionsAspirin might prevent the development of colorectal adenomas, but there is no evidence to support that sulindac and celecoxib might cure or prevent colorectal adenomas or familial adenomatous polyposis and that regular aspirin use might reduce the risk of colorectal cancer