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目的:以帕米膦酸二钠为对照,评价唑来膦酸治疗恶性肿瘤骨转移引起疼痛的临床疗效和安全性。方法:检索中国期刊全文数据库(CNKI),鉴定有关临床对照试验(RCT和CCT),采用RevMan4.1进行Meta分析。结果:共纳入24篇文献进行唑来膦酸有效性的Meta分析,17篇文献进行唑来膦酸安全性的Meta分析,7篇文献进行唑来膦酸平均起效时间的Meta分析,6篇文献进行唑来膦酸止痛维持时间的Meta分析。在有效性分析中,合并OR值为1.35(P<0.004),不良反应发生的合并OR值为0.78(P<0.02),平均起效时间合并的加权均数差为-0.39(P<0.002),止痛维持时间合并的WMD为3.37(P=0.21)。在敏感性分析中,得到了类似的结果。结论:与帕米膦酸二钠相比,采用唑来膦酸治疗恶性肿瘤骨转移疼痛更有效,不良反应更少,起效更快,但止痛维持时间没有显著性差异。
OBJECTIVE: To evaluate the efficacy and safety of zoledronic acid in the treatment of pain caused by bone metastases of malignant tumors with pamidronate disodium as control. Methods: The Chinese Journal Full-text Database (CNKI) was searched, and clinical trials (RCT and CCT) were identified. Meta-analysis was performed using RevMan 4.1. RESULTS: A total of 24 articles were included in the Meta-analysis of zoledronic acid availability, 17 articles were Meta-analysis of zoledronic acid safety, 7 articles were meta-analysis of zoledronic acid mean onset time, 6 articles Meta-analysis of zoledronic acid analgesia maintenance time was performed in the literature. In the validity analysis, the combined OR was 1.35 (P <0.004), the combined OR was 0.78 (P <0.02), and the mean time to onset combined was -0.39 (P <0.002) , And the WMD combined with pain-holding time was 3.37 (P = 0.21). In the sensitivity analysis, similar results were obtained. CONCLUSIONS: Zoledronic acid was more effective in treating bone metastases of malignancy compared with pamidronate disodium, with fewer adverse reactions, faster onset of action, and no significant difference in analgesic maintenance time.