Systematic Review of Sparfloxacin versus Ofloxacin in Treatment of Multi-drug Resistant Pulmonary Tuberculosis_West China Medical Journal

Authors：

YU Wentao , FU Li , ZHOU Junxiang , TANG Yao

Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

Keywords：

司帕沙星; 氧氟沙星; 耐多药肺结核; 系统评价

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【摘要】　目的　系统评价司帕沙星对比氧氟沙星治疗耐多药肺结核的有效性和安全性。　方法　计算机检索Cochrane图书馆临床对照试验资料库（2010年第2期）和PubMed（1978年-2010年10月）、EMBASE（1974年-2010年10月）、中国学术期刊网络出版总库（1978年-2010年10月）、维普（1989年-2010年10月）、中国生物医学文献数据库（1978年-2010年10月）；手工检索其他相关杂志。检索语种为中文和英文。纳入司帕沙星对比氧氟沙星治疗耐多药肺结核的随机对照试验。按Cochrane系统评价的方法评价纳入研究质量，用RevMan 5.0软件对数据进行Meta分析。　结果　共纳入8篇研究，Meta分析结果显示司帕沙星组与氧氟沙星组相比，痰菌转阴率、病灶显著吸收率、空洞闭合率均高于对照组，差异具有统计学意义（P lt;0.05）。　结论　现有的证据表明，司帕沙星与其他抗结核药物联用治疗难治、耐多药肺结核的疗效优于氧氟沙星的联用方案，但由于纳入的文献数量有限，质量参差不齐，存在潜在的发表偏倚。
【Abstract】　Objective　 To assess the clinical efficacy and safety of sparfloxacin versus ofloxacin in treatment of multi-drug resistant pulmonary tuberculosis (MDR-TB).　Methods　 Literatures were retrieved from PubMed (1978-October, 2010), EMBASE (1974-October 2010), Cochrane library (2nd volume, 2010), China Academic Journal Network Publishing Database (1978-October, 2010), VIP (1989-October, 2010) and CBM (1978 to October, 2010) by computer, and searched some other relevant journals manually. Chinese and English were both used in the search. Randomized controlled trials (RCTs) on sparfloxacin versus ofloxacin in treating pulmonary tuberculosis were included in this study. Meta-analysis was conducted by RevMan 5.0 software.　Results　 The meta-analysis of 8 included RCTs showed that the sputum negative conversion rate, focus absorption rate, cavity closure rate in the sparfloxacin group were significantly higher than the ofloxacin group (P＜0.05).　Conclusions　 The analysis indicates that combined treatment with sparfloxacin has a better effect in treating MDR-TB than with ofloxacin. However, the reliability of this review may be affected by the number and quality of studies included. Large-scale randomized controlled trials of high quality are needed to confirm the conclusions above.

Citation： YU Wentao,FU Li,ZHOU Junxiang,TANG Yao. Systematic Review of Sparfloxacin versus Ofloxacin in Treatment of Multi-drug Resistant Pulmonary Tuberculosis. West China Medical Journal, 2011, 26(10): 1491-1495. doi: Copy

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1. 　李拯民, 王魁民. 耐药结核病的流行趋势[J]. 中华结核和呼吸杂志, 2000, 23(2): 71-72.
2. 　Crofton J. Guideline for the management of drug-resistant tuberculosis[C]. WHO. 1997.
3. 　付志军. 氟喹诺酮类药物抗结核作用的评价[J]. 医药导报, 2006, 25(3): 204-206.
4. 　中华医学会结核病科学会. 肺结核化学疗法[J]. 中华结核和呼吸杂志, 1982(6): 381-385.
5. 　Higgins JPT, Green S. Cochrane handbook for systemactic reviews of interventions Version 5.0.2 [updated September 2010]. The Cochrane collaboration, 2010[EB/OL]. http://www.cochrane-handbook.org.2010-03-21.
6. 　黄朝生, 吴春城. 司帕沙星治疗耐多药肺结核疗效观察[J]. 中国抗生素杂志, 2000, 25(4): 302-303.
7. 　冀燕民, 董丽华. 司帕沙星与氧氟沙星对多耐药肺结核短期疗效观察[J]. 哮喘与肺部疾病, 2000(1): 9-11.
8. 　孙伟, 陈文一, 林存智, 等. 司帕沙星和氧氟沙星治疗耐多药肺结核病随机对比研究[J]. 中国抗生素杂志, 2000, 25(1): 53-55.
9. 　余荣深. 司帕沙星治疗耐多药肺结核近期疗效分析[J]. 中国防痨杂志, 2001, 23(5): 308-310.
10. 　聂玉生, 梁瑞武, 温冬梅, 等. 四种氟喹诺酮类药物治疗复治耐多药肺结核对比研究[J]. 中国防痨杂志, 2004, 26(1): 5-9.
11. 　王岗玲, 李学玲, 陈群, 等. 含司帕沙星方案治疗耐多药肺结核临床研究[J]. 职业与健康, 2006, 22(10): 721-723.
12. 　王岗玲, 李学玲, 陈群, 等. 司帕沙星治疗耐多药肺结核疗效临床研究[J]. 海峡预防医学杂志, 2006, 12(2): 18-20.
13. 　黄慧忠, 吴勇, 黄琳. 两种方法治疗耐多药肺结核疗效比较[J]. 中国现代医生, 2007, 45(09Z): 37-38.
14. 　马屿. 如何认识喹诺酮类药物的抗结核作用？临床如何应用？[J]. 中华结核和呼吸杂志, 2002, 25(12): 715-716.
15. 　Zignshina LE, Squire SB. Fluoroquinolones for treating tuberculosis[J]. Cochrane Database Syst Rev, 2008, (1): CD004795.
16. 　Khan KS, Daya S, Jadad AR. The importance of quality of primary studies in producing unbiased systematic reviews[J]. Arch Intern Med, 1996, 156(6): 661-666.

West China Medical Journal

Systematic Review of Sparfloxacin versus Ofloxacin in Treatment of Multi-drug Resistant Pulmonary Tuberculosis

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