地氯雷他定治疗慢性荨麻疹的系统评价

目的系统评价地氯雷他定治疗慢性特发性荨麻疹的疗效和安全性。方法以地氯雷他定（或地洛他定）和慢性荨麻疹为检索词计算机检索从2000年1月到20008年4月的Cochrane图书馆、PubMed、BIOSISPreview、BlackWell、VIP、CNKI等数据库，收集国内外所有关于地氯雷他定治疗慢性荨麻疹的随机对照试验（RCT），并手工检索相关杂志。运用Jadad量表评价纳入研究的方法学质量，采用RevMan5．0软件进行Meta分析。结果共纳入19个RCT，包括3448例慢性特发性荨麻疹患者，其中有6个采用双盲评价疗效，一个使用单盲评价疗效，其余12个均未使用盲法。Meta分析结果显示对慢性特发性荨麻疹患者，地氯雷他定与氯雷他定、咪唑斯汀、盐酸西替利嗪及特非那定的疗效相当，其RR（95％CI）分别为1．04（0．99，1．09）、0．99（0．92，1．07）、1．05（0．97，1．13）和1．10（0．84，1．44）；与咪唑斯汀、盐酸西替利嗪及特非那定的安全性相当，其RR（95％CI）分别为0．84（0．45，1．58）、0．67（0．39，1．15）、0．44（0．17，1．10）。地氯雷他定比氯雷他定安全性略优[RR=0．74，95％CI（0．55，1．00）。结论地氯雷他定是一种口服、有效、安全的新一代H1受体拮抗剂，治疗慢性特发性荨麻疹有显著疗效。

Efficacy and Safety of Desloratadine in Chronic Urticaria: A Systematic Review

Objectives To evaluate the efficacy and safety of desloratadine in the patients with chronic urticaria(cu). Methods We searched Pub Med, Blackwell, BIOSIS Preview, The Cochrane Library, VIP and CNKI electronically from January 1, 2000 to April, 2008. Relevant journals and conference proceedings were also handsearched. Randomized controlled trials (RCTs) and quasi-RCTs comparing desloratadine with other medicines in the patients with CIU were considered eligible. The quality of the included trials was assessed by the Jadad scale, and meta-analysis was conducted using Rev Man 5.0 software. Results Nineteen trials involving 3,448 participants contributed to the meta-analysis. The results of the meta-analysis indicated that desloratadine showed similar effect on the improvement of signs and symptoms compared with loratadine RR 1.04 and 95%CI 0.99 to 1.09, mizolastine in RR 0.99 and 95%CI 0.92 to 1.07, cetirizine RR 1.05 and 95%CI 0.97 to 1.13 and terfenadine RR 1.10 and 95%CI 0.84 to 1.44. And desloratadine had similar safety to mizolastine RR 0.84 and 95%CI 0.45 to 1.58, ceririzine RR 0.67 and 95%CI 0.67 and 0.39 to 1.15 and terfenadine RR 0.44 and 95%CI 0.17 to 1.10. Desloratadine was safer than loratadine RR 0.74 and 95%CI 0.55 to 1.00. Conclusions Desloratadine, the active metabolite of loratadine, is an oral, once-daily, non-sedating antihistamine that is effective in the treatment of CIU. Desloratadine provides rapid and sustained relief of CIU symptoms.